HomeMy WebLinkAboutAPPLICATION - 16-00683-684 - Sugar Mill ApartmentsCITY OF
REXBURG
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Amerim!; Family Community
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BUILDING APPLICATION
Commercial/Multi-family Residence
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use Digital Plans Included: ❑ CD ❑ USB ❑Dropbox ❑ Not Included
Permit Number: Permit Type: ❑ New ❑ Remodel ❑ Addition
Deposit Amount�$1000 New Const ❑ $250 Addition ❑ $100 Other Deposit Included with Application: ❑ Yes []No
1. Property Owner
Name:- LLC
Address: i?,e:!'-i A City: 20eAState: _T_ T-> Zip Code:
Phone &Type:r o,LA Z9n -3�h�0OfficegMobile Email: « CO't,
Under Idaho Building Code, a contractor must do the work for a Com ercial Building.
2. Applicagt
Name: a 1(Zd 4 f A -J7 Role: (Owner, Tenant, Contractor, etc.) A41-41 ilii_
Address: _11 2 &26ED AV6. City: JZFX6eJK4P State:i�A2 ZipCode: 6?g�
Phone & Type:'�61- Z" (A Office 0 Mobile Email: J� byaf9o✓(�a 1I 4a . eo.-f
Contact/Rep. Name: v L,996G61 Y OAncY4 Phone: Email:
3. Gene4Contor �e_-2_5>2j9
Name: Re i tra 'on #: Exp.:
Addres2 2 City: p /i State: Zip Code:
Phone & Type:20 - f - 2 ❑ 0 e ile Email:
Contact/Rep. Name: Phone: Email: Cr
General Con tractor Authorized Signature; L Date:
4. Project Descriptio
Address: tint! Whir ¢ Ht570U * -OR- Lot #:_ Block #:_Subdivision:
Type of work:
Check one:. KNew Construction ❑ Remodel* ❑Addition*
Check all that apply: I�L Framing qy Mechanical 0 Plumbing X Electrical
NOTE: Any sub -contractors invWlvedvAU need to submit their awn signed applications.
Description of work: N& 'SOUK- -ast-ogY AEAftP (950 ' 4T -&C Ca(MS a6e_aPA-Kc7
*Total cost of project - materials and labor: $ (used to calculate permit fees) # Of Buildings:
Building 1: Units f O� 6600 sq. ft Building 2: L�Units 1-0400 sq. ft Building 3: _Units sq. ft
Additional Buildings:
Utility, Misc, Private Garage: sq. ft Storage: sq. ft
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penaltyofperjury, I hereby cerd"at i have read this application and state thatthe information herein
is arrectand I swearthatanyinfomrationwhich may hereafterbe given by me in hearings before the Planning and Zoning Commission orthe City Council forthe Cityoffiexburg
shallbetruthfulandcomm I agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives ofthe
City to enter upon the above-mentioned property forinspectiom purposes. NOTE: The building official mayrevoke a pereniton approval issued under the provisions ofthe 2012
International Code in cases ofanyfalse statement ormisrepresemation of fact in the application or onthe plans onwhichthe permit or approval was based. Permitvoidifnot
started within 180 days. Permitvoid ifworkstops for 180 days.
Applicants Name (print):60014N`P WA -15,&q
Date: la ¢
Inspections must be called In before 8 AM on the day the inspection is requested. in ectionrequ called in after BAM will be scheduled forthe next business day.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit echnician- (208) 372.2341 Revised March, 2016