HomeMy WebLinkAboutAPPLICATION - 16-00575 - 117 S 2nd E - Mattson Apartments (Abri) - Civil Siteox`°x°tr"s, CITY o F Building Safety Department
o RMURG City of Rexburg
35 North 1°C East
OW
AmenrnsFamily Cammunhy Rexburg, Idaho 83440
BUILDING APPLICATION
Commercial/Multi-family Residence
For Office Use Digital Plans Included: 11 CD D USB D Dropbox D Not Included
Permit Number: Permit Type: ❑New ❑Remodel 13 Addition
Deposit Amount: O $1000 New Const O $250 Addition D $100 Other Deposit Included with Application: O Yes ONO
1. Propert�oO rer
Name: f P- r l< I l i
Address' &O,0 Fi -✓ ,, %r Ei r LY City: as> l State: 1p C le:
Phone & Type: ,y;03. �'tJ:3-%43fJ 0OfficeRQAobile Email: ve S.0 z
Under Idaho Building �Code, a contractor must do the work for a Commercial Building.
. App lica�AY
Name: ��_[Iy
.,'kse Role�'�O�ngr,Tenant,Contractor�Pp eCe� �✓
Address: PD 1344w 2,20 -city;" d-yt State: Zi Code: s 9&,,O
Phone& Typee_OEbSii%.4Si/ "fficeOMObile Email: fZr1tmBIffi%JIdAhbMwi/.Coni
Contact/Rep. Name: S..rt Phone: Email:
3. General ontractor
Name:; s✓« ers CPi A571t u0 . K Registration #: _ Exp
Address: ���? ,95"60 S' ?S / City: l I,f /e r State: Zip Code: SYS
Phone &Type:&6- ' I? Office D Mobile Email' lhid [eav96e,.�ireCC, �m
Contact/Rep. Name: ,4 ' , 4Arrkall Phone: Email:
General Contractor Authorized Signature: Date:
4. Project Description 'C"
Address:- /0 C a t �_ _ _ -OR- Lot #: _ Block #: _ Subdivision:
Type of work: �a.
Check one: JWNew Construction D Remodel* ❑ Addition*
Check all that apply: DO' Framing Ai� Mechanical @Plumbing lkr Electrical
NOTE: Any subcontractors involy d; 11 need to submit theirown signed applications.
Description ofwork:
*Total cost of project - materials and labor: $4,6,0 1. (used to calculate permit fees) # Of Buildings: CA -
Building 1: 41LUnits 36/5_/o.. sq. ft Building 2:..-21 Units 3&/Sb sq. ft Building 3: _Units sq. ft
Additional Buildings:
Utility, Misc, Private Garage: sq. ft Storage: sq• ft•
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Underpenalty ofperjury,Ihereby certlfythat t have readthis application and state tbatthe information herein
is correct and I sweartbat any information which may hereafterbe given by mein hearings before the Planning and Zoning Commission orthe (Sty Council for the Cityof Rexburg
shag be truthfuland correct. I agree to comply with all City regulations and State laws relating to the subject matter ofthis application and hereby authorized representatives ofthe
City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permiton approval issued under the pmvislins ofthe 2012
international Code in cases of any false statement or misrepresentation affect in the application or on the plans on which the permitor appmvalwas based. Permitvoid ifnot
startedwithin 180 days. Perrahvoid ifworkstops for 180 days.
Applicants Name (print): w5" ( C r' l er� Signature: Date -,2r �Isf -401
Inspections mustbe caged inbefore SAM on the daythe inspection is requested. Inspection requests caged in after SAM will be scheduled forthe nextbusiness day.
Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March, 2016