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Home My WebLink AboutAPPLICATION 1 - 16-00047 - 134 & 145 E Main St - Courthouse Security Upgrades - Phase 12 COMMERCIAL & MULTI FAMILY BUILDING PERMIT APPLICATION 1st E, REXBURG, ID 208- PARCEL NUMBER:___________________________( We will provide this for you) SUBDIVISION:______________________________UNIT#_________BLOCK#________LOT#______ (Addressing is based on the information - must be accurate) OWN E R N AM E :__________________________________CONTACT PHONE #______________________ PROPERTY ADDRESS:________________________________________________________________ PHONE #: Home ______________ Work ______________ Cell ___________________ OWNER MAILING ADDRESS:____________________CITY:____________STATE:____ZIP:______ EMAIL_____________________FAX___________________ AP P L I C AN T : (If other than owner)________________________________________________________ (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS__________________________CITY:_____________ STATE;________________ZIP_________ EMAIL_____________________FAX___________________ PHONE #: Home ______________ Work ______________ Cell ___________________ C ON T R AC T OR : __________________________________________________________________________ MAILING ADDRESS: ____________________________CITY_______________STATE______ZIP________ PHONE: Cell#___________________ Work#_______________________ Fax#________________________ EMAIL__________________IDAHO REGISTRATION # & EXP. DATE___________________________ How many buildings are located on this property? __________________________________________________ Did you recently purchase this property? NO YES (If yes, list previous owner’s name) __________________ Is this a lot split? NO YES (Please bring copy of new legal description of property) PROPOSED USE: _________________________________________________________________________ (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) – CIRCLE ONE APPLICANT’S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I have read this application and state that the 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. I 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 of the 200 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. _________________________________________________________________________________ ___________________ Signature of Owner/Applicant DATE Do you prefer to be contacted by fax, email or phone? Circle One WARNING – BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE! Plan fees are non-refundable and are paid in full at the time of application beginning Ja n u a ry 1, 2005. City of Rexburg’s Acceptance of the plan review fee does not constitute plan approval Please Complete the Entire Application! If the question does not apply fill in NA for non applicable Madison County 208-359-6200 134 & 145 E. Main St. (208) 359-6200 145 E. Main St.Rexburg ID 83440 kmuir@co.madison.id.us GPC Architects 189 N. Main St., Suite 112 Driggs Idaho 83422 ereiser@gpcarch.com (208) 354-8036 (208) 716-8649 TBD Two ● ● Commerical January 21, 2016 Email 5 Please take the time to answer all questions so that we can further assist you and your facility Thank You. What type of business will be performed ____________________________________________________ Will the business have food preparations? Yes No Will there be any cooking of foods? Yes No Will there be any deep fat frying? Yes No Will you have food disposal on site? Yes No Will there be any maintenance or mechanical work in the building? Yes No Will there be sumps or floor drains in the facility? Yes No Will the business require more parking? Yes No Will the business have any chemicals on site ? Yes No Is this business occupying an existing building? Yes No Will the business be doing any structural/or remodeling changes to the building? Yes No Any changes to the electrical?Yes No Any changes to the plumbing? Yes No Is this business planned to be the same with different ownership? Yes No Will there be a change of occupancy?Yes No ___________________________________________ ___________________ ____________ Applicants Signature Phone Date I Certify that The information that I have provided above is to the best of my knowledge accurate and true. Business Application Phone: 208.3)D[+RWOLQHRU7H[WLQVSHFWLRQV#UH[EXUJRUJ 35 N 1st E Rexburg, ID 83440 www.rexburg.org Jail and Courthouse (208) 354-8036 Jan 21, 2016 8 OWNER’S NAME ____________________________________ PROPERTY ADDRESS ________________________________ Permit# SUBDIVISION _______________________________________ PHASE ____________ LOT___________ BLOCK___________ R e q u i re d !!! E L E C T R I C AL Electrical Contractor’s Name __________________________Business Name __________________________ Address____________________________________City_________________State___________Zip_______ Cell Phone __________________________Business Phone ______________________________ Fax ___________________________Email________________________________________________ (COMMERCIAL/INDUSTRIAL) Total cost of electrical system (Contracted Amount) $__________ (Includes the cost of materials installed regardless of the party supplying it. The fees listed under this inspection type shall apply to any and all electrical installations not specifically mentioned elsewhere on this form). ɷ Up to $10,000 (total cost of system x 0.02) + 60 = $ ɷ Between $10,001 - $100,000 ( (total cost of system – 10,000) x 0.01) + $260 = $ ɷ Over $100,001 ( (total cost of system – 100,000) x 0.005) + $1,160 = $ Small Works (Contractors ONLY): $10 fee for work not exceeding $200 in cost and not involving a change in service connections. Does NOT require inspection. RESIDENTIAL N e w : Si n g le F a m i l y Dw e lli n g , i n c lu d i n g a ll bu i ld i n g s w i th wi ri n g b e i n g c ons tru c te d on e a c h prope rty . (*B a s e d on li vi n g s p a c e , s e e d e fi n i ti on b e low ) ɷ Up to 1,500 sq ft - $ ɷ 1,501 to 2,500 sq ft - $195 ɷ WRVTIW- $260 ɷ WRVTIW- $ ɷ Over 4,500 sq ft $ plus $IRUHDFKDGGLWLRQDOVTIWRUSRUWLRQWKHUHRI[# of additional 1,000 sq. ft. or portion thereof)). N e w : M u lti -F a m i ly Dw e lli n g (C on tra c tors Only ) ɷ Duplex Apartment $260 ɷ Three or more multi-IDPLO\XQLWVSHUEXLOGLQJSOXVSHUXQLW[RIEXLOGLQJV[RIXQLWV ɷ Existing Residence, Modular, Manufactured of Mobile Homes, and Detached Shop: $65 fee plus $10 per branch circuit, up to the maximum of the corresponding sq. ft. of the building ($65 + ($10 x # branch circuits)) ɷ Central Heating/Cooling Systems: $65 When NOT part of new residential or HVAC permit with no additional Wiring ɷ Spas, Hot Tubs, and Swimming Pools: $65 fee for each trip to inspect P u m p s -Wa te r, Irri g a ti on , Se w a g e (e a c h m otor) ɷ $65 up to 25HP ɷ$95 – 26 to 200HP ɷRYHU+3 MISCELLANEOUS ɷ Temporary Construction Services ONLY: 200 amp or less, one location (for a period not to exceed 1 year) - $65 ɷ Temporary Amusement: $65 fee plus $10 per ride, concession or generator ɷ Irrigation Machine: $65 for center pivot plus $10 per tower of drive motor ɷ Technical Service: $65 per hour ɷ Plan Check: RI(OHFWULFDO3HUPLW)HH ɷ Requested Inspection: $65 *Living Space – space within a dwelling unit intended for human habitation which may reasonably be utilized for sleeping, eating, cooking, bathing, washing, recreation, and sanitation purposes. An unfinished basement is considered part of the living space. ______________________________________ __________________ Signature of Licensed Contractor License number & exp. date Date Building Safety Department City of Rexburg 35 N 1st E Rexburg, ID 83440 www.rexburg.org Phone: 208.3)D[+RWOLQHRU7H[WLQVSHFWLRQV#UH[EXUJRUJ Madison County 134 & 145 E. Main St. TBD 11 SUBCONTRACTOR LIST Excavation & Earthwork:_____________________________________________________________________ Concrete:__________________________________________________________________________________ Masonry:__________________________________________________________________________________ Roofing:__________________________________________________________________________________ Insulation:_________________________________________________________________________________ Drywall:__________________________________________________________________________________ Painting:__________________________________________________________________________________ Floor Coverings:_________________________________________________________________________________ Plumbing:_________________________________________________________________________________ Heating:___________________________________________________________________________________ Electrical:_________________________________________________________________________________ Special Construction (Manufacturer or Supplier) Roof Trusses:______________________________________________________________________________ Floor/Ceiling Joists:_________________________________________________________________________ Siding/Exterior Trim:________________________________________________________________________ Other:____________________________________________________________________________________ N/A N/A N/A N/A N/A N/A N/A TBD N/A N/A TBD N/A N/A N/A TBD