HomeMy WebLinkAboutAPPLICATION - 17-00413 - 636 Centennial Loop - SFRv�
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CITY OF
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BUILDING PERMIT FORM q
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BUILDING PERMIT APPLICATION
New Single Family Residence
Building Safety Department
City of Rexburg
35 North 151 East
Rexburg, Idaho 83440
For Office Use
Permit Number: Zoning: Application Fee Paid: O $50
1. Property Owner
Name: SDH Construction
Address: 1825 Midway Ave City: Ammon state: ID Zip Code: 83406
Phone: 208-346-0846 Email: bertha(@col2l2ercreekhomesidaho.com
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 44 and complete the Homeowner's Exemption)
X No, I am working with the homeowner
2. Applicant
Name: SDH Construction Role: (Owner, Tenant, Contractor, etc.) Owner
Address: 1825 Midway Ave City: Ammon State: ID zip Code: 83406
Phone: 208-346-0846 Email: berthaC@copl2ercrgekhomesidaho.com
Contact/Rep. Name: Bertha Jones
3. General Contractor
Name: SDH Construction Registration #: RCE -37027 Exp.: 04/18/2018
Address: 1825 Midway Ave City: Ammon State: ID Zip Code: 83406
Phone: 208-346-0846 Email: bertha(@Coppercreekhomesidaho.com
Contact/Rep. Name: Bertha Jones Phol 2 -360- 7 Email: bertha(@col2percreekh!2mesidaho.com
General Contractor Authorized Signature: Date: 07/18/17
A copy ofyour state registration/license is required to be on fil . lis is the fi ' eyou have done work in the City of Rexburg, please provide
a photocopy 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: 636 Centennial Loop, Rexburg Idaho -OR- Lot #: _ Block #: _ Subdivision:
Project Description: New Construction
Square Feet: Building Total: sq. ft. # of Water Meters: 1 Water Meter Size:
o Main Floor: _1652 sq. ft. Fireplace(s) Being Installed? X X Yes ❑ No
o Additional Floors: sq. ft. • Hydronic Heating Being Installed? O Yes X No o Basement:
Finished 1285 sq. ft. Building Permitfeesfor new homes are charged based on square
Unfinished sq. ft. footage and the City's estimated valuation. For details on howfees
0 Garage 952 sq. ft. are calculated, contact the Building Department There will also be
Estimated Total Cost: $ 199.497.34 a pion reviewfee totaling 1090 of the building
permit fee.
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 1 swear that any
Information which may hereafter be given by mein 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 widi all City
regulations and State laws relating to the subject matter ofthis application and hereby authorizedrepresentatives ofthe 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 of any false statement or misrepresentation of fact in the application or on the plans on
which the permit or approval was based. PermitvoidifnotswrtedwiM[nl8Odays. Permit void ifwork stops for 180 days. n
Applicant's Name (print): _Shay Higley Signature: Date: 07118,17
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection req ests ced in aft/q CAM be scheduled for the next business day.
Inspection Hodlne-(208)372.2344 www.rexburg.org 1 Permit Technician -(208)372.2341