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HomeMy WebLinkAboutAPPLICATION - 17-00193 - 1140 Monroe Dr - SFRCITY OF REXBURG BUILDING PERMIT FORM100 CIA,bpdaw 1012016 America's Family Community BUILDING PERMIT APPLICATION New Single Family Residence Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 For Office Use Permit Number: Zoning: Application Fee Paid: ❑ $500 1. Property Owner Gtfkovw ^( Name: p Address: r G ]A` City: W -0— C1. State: Zip Code: "40 Phone: %Q-al� Email: -aC4_4&? nee -190 MaC.Cittiq� Under Idaho Building Code, a homeowner is allowed to do work on their own home. Are you a homeowner doing work on your own home? ❑ Yes (Skip to #4 and complete the Homeowner's Exemption) No, I am working with the homeowner 2. Applicant Sa'mR- Name: �S � Role: (Owner, Tenant, Contractor, etc.) Address: City: State: Zip Code: Phone: Email: Contact/Rep. Name: 3. General Contrac or Name: �A`W 2S 0b*lt Registration #: Exp.: Address: City: State: Zip Code: Phone: Email: Contact/Rep. Name: Phone: Email: General Contractor Authorized Signature: Date: A copy ofyourstate registration/license is required to be on file. If this is the first time you have done work in the City of Rexburg, please provide a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341. 4. Project Description Address: OR- ,r, a. A I Lot#:,ti Block#:_1lubdivision:_"ea SgIaK— Project Description: • Square Feet: Building Total: _ %3t tU sq. ft. • # of Water Meters: Water Meter Size: o Main Floor: to1.-l. _ sq. ft. • Fireplace(s) Being Installed?* Yes o Additional Floorsy tji)' j_sq. ft. • Hydronic Heating Being Installed? ❑ Yes` No o Basement: Finished sq. ft. Unfinished sq. ft. Building Permitfeesfornew homes are chargedbased on square .10-1— footage and the City's estimated valuation. For details on how fees o Garage 1641 _ sq. ``ftpp are calculated, contact the Building Department There will also be • Estimated Total Cost: $_ e -It i •S a plan review fee totaling 10% of the building permittee. APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of penury,[hereby certify that l have read this application and state that the Information herein is correct and l swear that any Information which may hereafter be given by me In hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct I agree tocomply withal[ City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval Issued under the provisions of the 2012 International Code in cases ofany false statement or misrepresentation of fact In the application or on the plans on which the permit or approval was based. Pamutvoid [foot started within 180 days.Permltvoid lfwork stops for 3/80 �days, Applicant's Name (print): a C J Signature: Date: Inspections .at be called In before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM will be scheduled for the next business day. Inspection Hotline- (208) 372.2344 www.rexburg.org Permit Technician- (208) 372.2341 C I TY OF REXBURG America's Family Community PERMIT POLICIES ACKNOWLEDGMENT Building Safety Department City of Rexburg 35 North 15T East Rexburg, Idaho 83440 The City of Rexburg Building Safety Department is determined to provide excellent customer service. In an effort to help you understand the City of Rexburg Permit Policies, listed below are several policies which you are required to know prior to proceeding with your project Any construction within the City of Rexburg which requites a permit shall not begin until an approved permit is obtained. If you do not have a Pink Building Permit signed by the Building Inspector, then you do not have an a roved permit. o Building without the pink building permit signed by the Building Inspector will result in double fees to be assessed and the project to be red tagged. If your project is red tagged, halting all construction, only a City Official may remove the red inn;ais tag. If the red tag is removed by anyone but a City Official, citations may be issued. No buildin may be occupied without receiving a signed Certificate of Occupancy. o If a building is occupied without receiving a signed Certificate of Occupancy; citations may be issued and the occupants may be evicted. Init Is A Certificate of Occupancy will not be issued without digital copies of the As -Built Plans. It is the Applicant's responsibility to turn in digital copies of the As -Built Plans when the project is completed. No Certificate of Occupancy will be issued without these plans. i Scheduling inspections is the responsibility of the applicant and their contractor. Inspections need to be called into the hotline and not to the inspector. Inspections called in later than 8 AM will be scheduled for the following business day. o Required inspections can be found on the inspection sequence page in this packet. If an inspection is not done, the inspector may require any measures to be taken to allow him to correctly perform the inspection. (Example: If the electrical rough in inspection is not done and the sheetrock has been put up, the inspector may require the sheetrock to inII is be removed in order to perform the electrical rough in inspection.) Construction on any project can begin ONLY when you have received a Pink Building Permit from the Building Department. Occupancy of any structure can begin ON when you have received an official Certificate of Occupancy from the Building Department. o A verbal approval does not constitute approval of these documents. Ultimately if you do not have a Building Permit or Certificate of Occupancy, the above policies will be enforced. These documents must be signed by the appropriate Initial authorities from the City of Rexburg. Any approvals can be verified by calling (208) 372-2341. It is your responsibility to inform anyone on your project of the above policies. All sub -contractors will be held to this standard with no exceptions. o The above policies will be enforced to all, regardless if this information is passed on to them or not Initizfs CC { � Applicants Name (print):ar� J� Signature: Date: 3N Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM will be scheduled for the nextbr iness day. Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised 2/2017 CITY OF REXBURG America's Family Camrnanity PROPERTY LINES Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 Each site plan that is submitted to the City of Rexburg for the Building Permit process requires that property lines are shown accurately. It is the Developer's responsibility to correctly identify on the site plan the location of these lines in reference to the public right-of-way, other adjoining property lines, the street, other structures and all utility lines. The Developer should find property pins that are still available at the lot in question. If these pins do not exist or have become unrecognizable then a new survey should be performed. Accurate property line information is a must for a timely review. In addition to finding existing property pins, legal descriptions should be checked. The best way to identify property line location is with a land survey. The City of Rexburg has aerial photos and a parcel line layer that can be checked, but they are only a tool and are not guaranteed for accuracy. This information is available at madison.rexburg.org. If you want to request a copy of your lot information, contact the Community Development Department. I have read and understand the above requirements. Signature Tata - Printed Name 3/51/17 Date Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised 10/2016 p4pexuugc, �d CITY OF ° REXBURG n,v A,nerfedsFemily Cornnunity Excavation & Earthwork: �Y SUBCONTRACTOR LIST Concrete: N�\1Gk\rinci Ct)0CAr V k4/ Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 �V) Drywall: Painting:��y� Floor Coverings: CG ' &�� 1 y'red— Plumbing: `\V` t `c � � 9 Beating: Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses:'PViC V e+c�t Cat Floor/Ceiling Joists: '(apo \Neje-' cOcyz) Siding/Exterior Trim: Other: Inspection Hotline -(208)372.2344 %mvv.rexburgorg permit Technician -(208)372.2341 Revised 10/2016 Z�`:��i�[3�i�►"a�I�T.aifS►ri�L�+srZ►I[�7►'► — i Roofing: �4 Drywall: Painting:��y� Floor Coverings: CG ' &�� 1 y'red— Plumbing: `\V` t `c � � 9 Beating: Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses:'PViC V e+c�t Cat Floor/Ceiling Joists: '(apo \Neje-' cOcyz) Siding/Exterior Trim: Other: Inspection Hotline -(208)372.2344 %mvv.rexburgorg permit Technician -(208)372.2341 Revised 10/2016 CITY OF 7����� a z 1�XBURG o ° llv '�aq,w a •.J Nnerfrn'rFmuOy Canonunfly BUILDING PERMIT FORM ZZ� uremelopacs BUILDING APPLICATION New SFR Electrical Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 rer omen: Use Permit Number. d.- .0 rlcctrlcal Fee lIaid 1. propyy O�wner Name: OA&bAyr S Address 1554 S - 4A00611r.. (two SWI Clty:fTState: 1 Zip Code: S3�`iU Phone: SCNR- 2111`0 Email: aVtY�4 M.: Q• eev> Under ldnho Building Code, a homeowner Is allowed to do work on their own hofne. Are you a homeowner doing work on your own home? 0 Yes (Skip to N3 and complete the Homeowner's Exemption) Cvmo, I am working with the homeowner 'l. Electrical Contractor Business: Ge� Jf? r^e- State License S: �ig�'� Exp.: Address: Y //CA City: fri r- State; TM Zip Code: Phone: �•- Email: f�a��iu_•"COratar%• (u f✓f Contact/Rep.Nante:-Phone-.• Email; Blecti{c'al �oiitrae(o'r /lufliorized Signatdrei Date: Acopy ofyoarstate rer3lstrntfon/licenseisrequfre be oil file. f uslsthe/irsttlmeyouhaveeloneworlchlfliaCityclRexbarg,pleaseprovide a photo copyofyourlicense..ffyonoreunsfx•eI our• license IsonfIle, please check with tile Permit Technician bycallhng(200)372.2341. 3. Project Description - A Address:OR- Lot#:�Block-J .Subdlvisiont V-4 Description ofwork: tsI ❑ Now SFR Construction: _ 1.11.0—sq. ft. Peesfm•inew constriction are chnr0r`bysgnaie footage: Up to l,50osq. ft. =$130+$65 for each additfonall,000 sq. f .or portion thereof o Upto1,500sq,ft=$130. Up to2,500sq.f.-$195.Upto3,50osq.ft.=$260.Uptoh500sq.ft.4325,etc. (i.e.a home tvfth 3,675 sq. ft. willbe charged $325) ❑Spas/Pools/Generators:❑ Yestf No e Note Mntspns/pnois/penernfors are not Mduded In squarefootage costs and vvfll be Charged $65 per Inspection. APPI.ICAN MIGNATURU, CFRI IFICRInON AND AUTHORIZATION: Underpenallyofperpuy, I herubycerillythat I have read tills application and state that the Information herefil is correct and I swear that any Information which may hereafter be given by oa in hall before the Planning and Zoning Commission or the City Council for the C.Iryofilexburg sbali be truthful aid correct, i agree to cooply will all City regulations and Statelaws relating to the subject malterof lids application and hereby autholaed representatives of the citytoeolor upon the above anmitioucd propoly for inspalions paryoses. NOTE: Tile fnlldingomdai,lay Wake 0 pernnilol upprov:d issued tender the III vlslonsortile 2012 l[it eruallo al (:ado In cases Unity false slatenanl or adsrepresentatlon of fact In the appilcnllmn or on ties plans on which the pennitorapproval Ives based. Pendt vold Croat started within 100 days. Permit void It work stops for 100 days. Applicant's Name (print); I'laSitij- Signature: Inspections must be called in before OA14 on the day the Inspection is requested. Inspection requests called In aner DAM will be scheduled for the next foulness day. Inspection Bullion -(200)372.2344 www.rexfurgorg PernNtTechnlchn-(700)372.2341 CITY OF REXBURG c- Arnedm3 A11,111p• CorrOnnnly BUILDING PERMIT FORM 110 u,t.oa 101106 BUILDING APPLICATION New SFR Mechanical Building Safety Department City of Rexburg 35 North Ist East Rexburg, Idaho 83440 For Offlce Use Permit Number: ❑ Mechanical Fee Paid 1. Property Owner Name: VAAr' hY1Ytf VYI+b Address: 1601 S- 'Yl --U1 City: Ae-`ebg',J�State: W,3,.,�,,Zip Code: 1-1W! Phone: `5&q -21111 Email: �lR �i.C7 (tui 1YL!�l ,�(p�"p—dank Under Idaho Building Code, a homeowner is allowed to do work on their own !tome. Are you a homeowner doing work on your own home? ❑ Yes (Skip to #3 and complete the Homeowner's Exemption) ra, I am working with the homeowner 2. Mechanical Contractor y LZ(✓ Business: olnv ' (+ b State License #I 0l Z ✓r-� Z Exp.: Address; t - City: 4 - Stat g: �_ Zip Code: Phone- 2b Z Email: O ce: f//f9"e�L7'/cAe-fC !- Contact/Rep.Name: I Phone: 7 Email:�_��Mechanical Contractor Acopy ofyourstateregfstratIan/license Is required to beonnle.Ifthis Ist firstUmeyouhavedoneworkintheCityofRexburgpleaseprovide a photocopy ofyour license. Ifymf are unsure if your license is on file, please check with the Permit Technklan by calling (100) 372.2341. 3. Project Description Address:OR- Lot4 Block#I_'ISubdivision:. t15-clt/Wf Description of work: Ie i - ❑ SPR Construction:_ X-bLip_sq.ft. • Feesfor new construction are charged bysquarefootage: Up to7,500sq.ft.=$1304$65foreachaddltlona11,000sq.ft. or portion thereof. o Up to 1,500 sq. ft. = $130. Up to 2,500 sq. f t = $195. Up to 3,00sq. ft. = $260. Up to 4,500 sq. ft. = $325, etc. (i.e. a home "�with 3,675 sq. ft. will be charged $325) ❑ Number of Fireplaces: 1 • Note thatprepplacees are not [Included in squarefootage costs and will be charged $65 per Inspection. 11flydronic Heating: Nies • Note that hydronk: heating Is not Included In squorefinotoge costs and willbe chargedand additional$65 # ($10 x # of manifolds/zones) APPLICANT'S SIGNATUJIM, CEWI-II'ICATION AND AUTHORIZATION: Under penalty of perjury, l hereby certify that I have read this application and state that the Inrminatian herein I, correct and 1 swear that any Information which may hereafter be given by me In hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct. I agree to comply with all City regulatimn and Suite laws Ielal Ing to the subject matter of thbi applucation and hereby authorized representatives niche City to enter upon the above-meinloned property for inspections purposes. NOTE: The building official Any revoke a permit on approval Issued under the provisions of lite 2012 International Code In cases orally false statement or misrepresentation of tact In the appllcatlon or on the plans on which the permit or approval was based. Permit void If not started withln 180 days. Permit void If work stops for 180 days. Applicant's Name (print): �a fef J t" r 2 Signature: �u—� Date: Inspections must be called In before 8 AM all the day the Inspection Is requested. Inspection requests called In after 8 AM will be scheduled for me next business day. Inspection hotline- (2 08) 372.2341 ww•sv.rexburg.org Permit TeclmWin - (200) 372.2341 GQRR%cUgO CITY OP a a tlTtrbllr)!3 BUILDING PERMIT FORM 1�0 1t.C21�c- V l�V' Updaxd 10/core nv •'q'rx ,p• Nndrfm}Fnmily Cornnnndy BUILDING APPLICATION New SFR Plumbing Building Safety Department City of Rexbttrg 35 North 11t }fast Rexbtug, Idaho 8344.0 For Of ce Use.' Pei niit,Number: b Plumbing pee.Paid 1. Property Owner Name:\fib(*vhHys-f Address: 861 S. sfeablCtty:— re State:--ZtpCode: Phone: 'yag-2 14 y4nqr3Q trtiyfehne� %1�no Prodi-� Under Idalto Building Corte, a homeowner is allowed to do wo?* on thell• own /tome. Aro you a homeowner doing work on your own home? ❑ Yes (Skip to t!3 and complete the Homeowner's Exemption) ?No, l ant worldng with tiro homeowner 2,PluntbhtgCIometer Business: Lt Gy5�y" l�Itir�� ^0 I�L� StaAteLicenseff: Address; SiEfS C 5W -1E4 M4,1 •/ / Tr i•'�v 1 �S to:: Zip Code; y'Ci Phone: 706 5-.35 /' 6 Email) Luo% 'r�r tirwd ,� E!:' aA,,', eco-•, Contact/Rep. Name; 6d or 0-71e- Phone: _ EMAI l: PldmbldgClintracto'rAtitloi'izei!$Igitafdre: dt c Date: .3 / Acopy ofyourstate registmttoir/llcenselsrequired to eonjfle.lftldsls/IrsttfmeyouhavedoneworkfittheCityoftlexburg,pleoseprovide rt photo copy ofyour license. lfyou are unsure Ifyour license is on filo, pleose check Ivlth Ure Pmmit TechiNclon by calling (200) 372.2341, 3. Project Description Address: OR. Loth 4-131ock4: -j,Subdlvlsion:-4j �C 3 Sgv44Ct Description ol4ork: tye.,i ffii; ❑ New SPR Construction:at 3LAO_sq,R, • peasforflow construction arechepeelbysgunrefoetnge:Upto1,50osel.f.v$130+$65foreach oddfdonall,000xg.f.orpofxon thereof. o Upto 1,500sg,ft.-$130. Up to2,500sg,f-=$19,5. Up tn$500sq,ft.=$260. Up tu4,500sg,ft=$325, etc, (i.e.a hence with 3,675sg. Jt. wfif bo charger/ $325) ❑ Hydropic (In -Rom.) Heating: 13 Yes 6ACI • Note that lWdronfcheating Isflat included hisgfmr•efooingecosts and will bechmDed$65+($10x#ofmmnlfolds/zones), APPLICANT'S SIGNATn6R,CORTIPICATION AND AUTHORIZATION: Under peuollyuf p.nury, I Ilerabyearllry alit I Imva read ads Application And slate trial theinformatlon heroln Is correannd Isivrar that Any Infntmallon whlch nmy hereafter be given by Ire In Ilenrhlgsberar, Zile Nanning And 20111ng C01111n1551aA or II ICIlyConn41 for the City of HeXblog shall be tnnhfnl and nrtrttt. I agree to cotaply with nil cilyregnlnilons and slalelaws relating to Iimsabled mAnerof Ihk Application And herobymrhothed representatives of the city to Prier 111,01/ lheabove-mentioned property for Inspections purposes. NOTg: Tire building oficial may revoke per alt on approval Issued colder (lie provisions of the 2a 12 International Code It, ases orally this. slalement or misrepresentation Wact In the Application Arne thoplAns all which rho permitarnpproval was based. Permit void Illlot statledwllhlnlll0dayl. Peroat vold lfwnrll slops for l Godoys. ApplicanesName (print); TGfWqjyt:,H-_Signature: � �- Date:_ 4/11/1-7 IlnpeclIons Inrit Imealled fn heforo 0 AM oil IIP day Ibo Inspucllun Is requested. Iaspectlan laulquis called in after 0 A svlll be scheduled toy the next business day. Irspeeilml ilotllno- (200) 372.2341 svww,roxbmg,org Parnll Toehnlclall- (200) 3722341 CITY OF REXBURG rn� America! Family Community Affidavit of Legal Interest Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 State of Idaho County of Madison lna C -Dos -b -i I to l �� S. ✓ c� r tX iJs 1� c sic Zip Name Address �e City Being first duly sworn upon oath, depose and say: (If Applicant is also Owner of Record, skip to B) State I� A. That I am the record owner of the property described on the attached, and I grant my permission to: Name Address to submit the accompanying application pertaining to that property. B. I agree to indemnify, defend and hold Rexburg City and its employees harmless from any claim or liability resulting from any dispute as to the statements contained herein or as to the ownership of the property which is the subject of the application. Dated this LI i'_ day of n 20 1-7 Signature Subscribed and sworn to before me the day and year first above written. JANAE BINGHAM NOTARY PUBLIC STATE OF IDAHO My commission expires: V 101 // 2V �% Inspection limline- (208) 372.2344 w .rexhur&org Permit Technician -(208)372.2341 Revised 10, 2016