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Home My WebLink AboutAPPLICATION & PLAN - 17-00138 - 117 Madison Ave - New Outside Entrance & DuplexJQ pY%eUgC CITY OF 1tGXBLTRG BUILDING PERMIT FORM1�2 0 updama m/2o1c Americai Family Community BUILDING APPLICATION Single Family Residence Remodel Building Safety Department City of Rexburg 35 North 1St East Rexburg, Idaho 83440 For Office Use Permit Number: Zoning: Application Fee Paid: El $10 Property Ow N Name: �y�— lD✓ Address: 01.1 40 o ib o. .e_ City: State: _ Zip Code: . �{ 4y i Phone: —� Email: 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 Name: Role: (Owner, Tenant, Contractor, etc.) Address: City: State: Zip Code: Phone: Email: Contact/Rep. Name: 3. General Contractor Name: Registration #: Exp.: Address: City: State: Zip Code: Phone: Email: Contact/Rep. Name: Phone: Email: General Contractor Authorized Signatures Date: A copy ofyour state registration/license is required to be on file. If this is the first timeyou have done work in the City of Rexburg, please provide a photo copy ofyour license. lfyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341. 4. Project Description Address: / �2 eld 4f c -e �L jf,�. p % 9 Project Description: �(/ 11> 4 L 4w a r7n uc— �6 LE may(_ • Estimated Total Cost: $�C'x�U k • Check All Included in Scope of Work: ❑ Mechanical Work Cost: $WA ❑ Electrical Work Cost: $ ,�� ❑ Plumbing Work Cost: $Z/d_ Note: Any contractors involved will need to fill out their respective application. • Fireplace(s) Being Installed? ❑ Yes X -No Building Permitfees for remodels are charged based on cost The application fee applies toward the fee total. For details on how fees are calculated, contact the Building Department There will also be a plan reviewfee totaling 10% of the building permitfee. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that l have read this application and state thatthe information herein Is correct and I 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 [agree to comply with all 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 ofthe 2012 International Code In cases of any false statement or misrepresentation of Net in the application or on the plans on which the permit or approval was based. Permitvoidlfnut started within 180 days. Permitvoid ifworkstops for 180 days. p/ Applicant's Name (print): Z J&X l9✓Signature: �K Date: 34LA 7 Inspections must be called In before 8 AM on the day the Inspection Is requested. Inspection rguests 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 IT Y OF REXBURG 0& Arnericni Family Community PERMIT POLICIES ACKNOWLEDGMENT Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 The Cityof 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 requires 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 approved permit. 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 nitials Official may remove the red tag. If the red tag is removed by anyone but a City Official, citations may be issued. No building 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. rtiafs 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 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 al: put up, the inspector may require the sheeu-ock to 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 ONLY when you have received an official Certificate of Occupancy from the Building Department. These documents must be signed by the appropriate authorities from the City of Rexburg. Any approvals can be verified by calling (208) 372-2341. o Even if you hear from an inspector that'you're good to go', ultimately if you do not have a Building Permit or Certificate of Occupancy, the above policies will be enforced. I Is 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. I ' Applicant's Name (print): Signature: Date: �3 -r' Inspections must be called in before 6 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.rexbtirg.org Permit Technician -(208)372.2341 Revised 10/2016 CITY OF REXBURG Amerlm's Family Community HOMEOWNER'S EXEMPTION Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 As of January 1, 2006, the City of Rexburg can no longer sell permits without having a copy of your State registration number or your exemption from the State registration. Please fill out this form showing your exemption and send it with your permit application. Idaho State Statute allows a homeowner to do work on their own residence: An owner performing construction on the owner's personal residential real property, whether or not occupied by the owner, provided however, this exemption shall not apply to an owner who is otherwise regulated by this chapter who constructs a building, residence or other improvement on the owner's property with the intention and for the purpose of promptly selling the improved property, unless the owner has continuously occupied the property as the owner's primary residence for not less than twelve (12) months prior to the sale of such property; Title 54, Chapter 52, Subsection (2) I hereby certify that the above information is true and correct to the best of my knowledge. 4 Signata e Print fqame �- Yl - AI r) Date Permit Technician -(208)372.2341 v .rexburg.org Revised 10/2016