HomeMy WebLinkAboutAPPLICATION - 17-00544 - 776 S 2275 W - New SFR�l
CITY OF
RMURG
Americas Family Community
PERMIT POLICIES ACKNOWLEDGMENT
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
The City of 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
a roved ermit.
o 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 Official may remove the red
ini ials
i tag. If the red tag is removed by anyone but a City Official, citations may be issued.
No buildin 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 he issued and the occupants
may be evicted.
Initials
A Certificate of Occupancy will not be issued without digital copies of the As -Built Plans.
o It is the Applicant's responsibility to turn in digital copies of the As -Built Plans when the project is completed. No
Certificate of Occupancy will be issued without these plans.
Ini ials
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 Required inspections can be found on the inspection sequence page in this packet 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 put up, the inspector may require the sheetrock to
Initials 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.
o A verbal approval does not constitute approval of these documents. Ultimately if you do not have a Building Permit or
Certificate of Occupancy, the above policies will be enforced. These documents must be signed by the appropriate
Initials authorities from the City of Rexburg. Any approvals can be verified by calling (208) 372-2341.
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.
FX V� o The above policies will be enforced to all, regardless if this information is passed on to them or not.
Applicant's Name (print): ��1�i�11$�nJ Signature: 1 C�l �U` 7 + Date:
Inspections must be called in before 8 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.rexburg.org Permit Technician -(208)372.2341 Revised 2/2017
CITY OF
REX-BURG
nv
America's Family rae m mhy
PROPERTY LINES
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
Each site plan that is submitted to the City of Rexburg for the Building Permit process requires that property lines
are shown accurately. It is the Developer's responsibility to correctly identify on the site plan the location of these
lines in reference to the public right-of-way, other adjoining property lines, the street, other structures and all
utility lines. The Developer should find property pins that are still available at the lot in question. If these pins do
not exist or have become unrecognizable then a new survey should be performed.
Accurate property line information is a must for a timely review. In addition to finding existing property pins,
legal descriptions should be checked. The best way to identify property line location is with a land survey. The
City of Rexburg has aerial photos and a parcel line layer that can be checked, but they are only a tool and are not
guaranteed for accuracy. This information is available at madison.rexburg.org. If you want to request a copy of
your lot information, contact the Community Development Department.
I have read and understand the above requirements.
I'AM
Signature
Printed Name
q/5-/1-1
Date
Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised 10/2016
CITY OF
REXBURG
c1V
America's Family Community
BUILDING PERMIT FORM 100
Updatm Vizors
BUILDING PERMIT APPLICATION
New Single Family Residence
Building Safety Department
City of Rexburg
35 North 1gt East
Rexburg, Idaho 83440
For Office Use
Permit Number: Zoning: Application Fee Paid: 13$500
1. Pro ert ner
P Y
Name: L�/1Yt _/ I ^9
Address: g5� S. �e9�Ca ,sem Wtt:5 2u�_ City: tf::'b'' State: 10 Zip Code:
Phone: 5 fit- Lllu Email: ala c��kYFw �r� , _care
Under Idaho Building Code, a homeowner is allowed to do work on their own home.
Are you a homeowner doing work on your own home?
0 Yes (Skip to #4 and complete the Homeowner's Exemption)
iTNo, I am working with the homeowner
2. Applicant CC'
Name: `y'lYC. SCS S Role: (Owner, Tenant, Contractor, etc.) _
Address: City: State: Zip Code: _
Phone: Email:
Contact/Rep. Name:
3. General Contractors�_5 �1
Name: ✓ � fl',.L X1.5 a1op� Registration #: I 1 � � Exp.: 1211-07
Address: City: State: Zip Code:
Phone: Email:
Contact/Rep. Name: Phone: - /Emmail:
General Contractor Authorized Signature: J` -t r� ZLy_Y Date:
A copy ofyour state registration/license is required to be on file. If this is the first timeyou have done work in the City of Rexburg, please provide
a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
4. Project Description
Address: Huts • a Z ISS -OR- Lot #: _t Block #: Subdivision:
Project Description:
• Square Feet: Building Total: I DKV sq. ft. • # of Water Meters: Water Meter Size:
o Main Floor:)�1H� sq.ft. • Fireplace(s) Being Installed? 0 Yes q No
o Additional Floors: sq. ft. • Hydronic Heating Being Installed? 0 Yes O No
o Basement:
Finished —fir sq. ft. Building Permit feesfor new homes are charged based on square
Unfinished�1Sb Sq. ft. footage and the City's estimated valuation. For details on howfees
o Garage "AS< sq. ft. arecalculated, contactthe Building Department Therewillalso be
• Estimated Total Cost:$ aplan reviewfee totaling 1035 ofthebuilding permitfee.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I have read this application and state that the Information here[. 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 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 approvalissued under the provisions ofthe 2012 International Code In cases ofany false statement or misrepresentation other in the application oron the plans on
which the permit or approval was based. Permit void if not started within 180 days, Permit void ifwork stops for 180 days. r/��j/----�
Applicant's Name (print):��� L �0�41� Signature: h - Date: qtr(
Inspections must be called in before 8 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.rexburg.org Permit Technician - (208) 372.2341
pexeop
CITY OP
a REXBURG
civ
s„a o • Ante !call Family Can unmety
BUILDING 'ERMiTFORM 130
ucema 10/:616
BUILDING APPLICATION
New SFR PIumbing
E
Building Safety Department
City of Rexburg
35 North 1st Bast
Rexburg, Idaho 8344.0
Por Office Use. '.:
Permit Number: _ p Plumbing Fee paid.,
1. Prop`ertyOwner
Name: )z C. Off—V .OJS
Address: City: State: Zip Code:
Phone: Butall:
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 93 and complete the Homeowner's Exemption)
No, l am working with the homeowner
2.plumbing Cntractor
Business: Ue5 .Zc State License ti; Pt P1-e-#Vlexp.: ll it�G
Addl'esS: 3,E E na i eC a2' t ,---1S t�Zip Code: / CI6
phone: 74165-35 /' U Rmail: 11pledfn1oy ye„dr � ldNUG, eco ,
Contact/Rep, Name: Vd Of E phone: BM4I:
plumbing confractorAutho 92ed Signature: Date: .�
A Copy ofyours[afe replstt•admt/license is required to ental¢. If this is first timeyou have done work In the City ofRexbwg, please provide
a photo copy ofyour license. Ifyou are unsure lfyour license Is on flue, please check with the Penni! Technician by calling (208) 372.2341.
3. Project Description
Address: "11(. S. as-TSr1 •OR- Lot S:ZBlock h:' Subdivision:
SJfrrnec"���`i
Description of work: Nc j O 'W -e _
❑ New SFR Construction: 1H�Al-P sq, ft,
frees for new constr'ucli0n ore cliafged by.squo'e footage: Up to l,500sq. ft. = $130 + $65 fbr each addilionall,000 sq. f . or po)Tiorl
thereof,
o Up to 1,500 sq, ff. =$130. Up W,500 sq.R, =$19.5. Up to 3,500 sq. ft. = $260. Up to 4,500 sq. ft. -$329, etc, (i.e. a
home with 3,675sq. f . will be charped $325)
13 Hydronic (h1 -Flom') Heating: O YesQ(No
6 Note that hydronlc heating is not included lnsquorefootage costs and will be cimrged$6.5+($10xllnfnrnhTofds/7ones),
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under pemOtyofperpsry, I hereby certify that l have read this application and state that the Information heroin
Is correct red 1 mvear thn, any Information which may han n for be given by nue In hearings before the Planning and %oningConnnlsslon or Ilia City Council for the City of IteBhurg
shall he tnnhrnl auA mrred. I nglee to complywlib all City regldalIons and Stale lewsrelatingto llwsnblecl oca t-ofthis applIonian and herebyounmrlxad representatives oftho
Cityto anter span the above mmunnnnd property lm• Inxpttllans purpose.¢, NOTE; The building official may revoke penult au spin oval Issued under the provisions of the 201 L
lilt.) net Code In "Sea rally raise statement or ndsrepresennllou of fact the nppllcntion or on the plans on which the pernsltor approval tons based. Permit veld Near
started wItI le 1110 days. PeruUt void If ein li stops far 180 days.
i
Applicant'sName(prhlt)i I q, 1�Je-nu ,,___Signature:
Inspections must bo culled 61 before 8 AM on the day the Inspection Is minested. Inspecl Ion reque.qu called Ili after U AM ivill bo scheduled for the next business day.
I nspolml Ibillion- (200) 372.2344 wwwa'oxboreorg Ponnll Technician - (200) 372,2341
h°�papA4�° CITY OF
REXBURG
Amerlm3 Family Community
BUILDING PERMIT FORM 110
apd.udla/2016
BUILDING APPLICATION
New SFR Mechanical
Building Safety Department
City of Rexburg
35 North list East
Rexburg, Idaho 83440
For Office Use
Permit Number: - ❑ Mechanical Fee Paid
1. Property Owner
Name: See PCey�035 -
Address: City: State: Zip Code:
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 #3 and complete the Homeowners Exemption)
❑ No, i am working with the homeowner
2. Mechanical Contractor I r W,
Business: 01 tr ir!9&zhkC State License #: 017-5-5-7— Exp.: �✓ 5i `g
Address: t e ' City:Stat : � Zip Code:
Phone: `6 ---2-Em 11: ur .0,4 a- r
Contact/Rep. Name: rhL+ I Phone: - Email: ,
Mechanical Contractor Authorized Signature: r^ ~'1 Date: d
A copy ofyour state registration/licensa is required to be on file. If this 1st first tlnieyou have done work In the City of Rexburg, please provide
a photocopy ofyour license. ifyou are unsure lfyour license Is on f ie, please check with the Permit Technician by calling (208) 372-2341.
3. Project Description
Address: 1W %• h/ OR- Lot #:: Block #: g Subdivision: 2>Jry)ma(�4gA
Description of work: tj2fAe
❑ SFR Construction: J`A l V sq. ft.
a Fees for new construction are charged by square footage: Up to 1,500 sq. ft = $130 + $65 for each additional 1,000 sq. ft. or
portion thereof.
o Up to 1,500 sq. ft = $130. Up to 2,500 sq. ft. = $195, Up to 3,500 sq. ft. = $260. Up to s 500 sq. ft. = $325, etc. (i.e. a
home with 3,675 sq. ft. will be charged $325)
ONumberofFireplaces: V
e Note that fireplaces are not included In square footage costs and will be charged $65 per Inspection.
❑ Hydronic Heating: '0
6 Note that hydronk heating is not Included In square footage costs and will be charged and additional $65+ ($10 at # of
manifolds/zones)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, l hereby certify that 1 have read this application and state that the Information
herein Is correct and i swear that any Informatlon which may hereafter be given by me to hearings before the Planning and ZoningCommission or the City Council for the City of
Rexburg shall be truthful and correct. I agree to comply with all City regulations and Slate laws relating to the subject matter of thf{'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
provislons of are 2012 International Code In cases crony 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 lfwork stops for 180 days.
Applicant's Name (print):_G Signature::�4 ' �� Date: 9 J5AN
Inspections must be called In before a AM un lire day the inspection is requested. Inspection requests called In after a AM will be scheduled for the next business day.
Inspection Iloaine - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
Otpaxougc
CITY OF
REXBURG
cw—
Au¢r(rn4 Family Canunnxily
BUILDING PERMIT FORM 1Z0
Ura.xdsdfmrs
BUILDING APPLICATION
New SFR Electrical
Building Safety Department
City of Rexburg
35 North let East
Rexburg, Idaho 83440
For Office Use`
PermitNumh.er:- ,p Electrical Fee Paid
1. Property Owner
Name; )Zc PX%j;D.)S
Address: City: State: Zip Code:
Phone: Email: _
Under Idaho BuildbW Cade, a homeowner Is allowed to do work on their own home.
Are you a homeowner doingwork on your own home?
0 Yes (Skip to 83 and complete the Homeowner's Exemption)
0 No, I ant working with the homeowner
2. Electrical Contractor t
Business: Svsteraral EIGexJtZ est StateLlcense#: �f8`C8G Exp.:
Address: r CiI rP r State: J—Z^ Zip Code: F3 f'
Phone: — Email: . ((�S�Irt+1M'1ia�•�u t✓(
Contact/Rep. Name: a Phone: Emaih
Electrical CotitractorAutliorized Signature: Date;
A copy ofyour•state reglstration/license is require be onfile. f its lsthefrsttimeyou have done workin the Chy of Rexburg, please provide
a photo copy ofyour license. Ifyou aur license Is on file, please check with the Permit Technician by calling (208) 372.2341.
3. Project Description
Address; *Thr S• "--m W -OR• Lot 41:1 BlockH:-S-.Subdivision: ^r+meCFaQ�
Description of work: P f4 - N—<,,g
0 New SFR Construction: \ t-'it'ttI sq. R.
feesfor new construction are charged bysquare footage., Up to 1,500sq. ft. =$130 4 $65 for each additional 1,000 sq. ft. or
portion thereof.
o Up to 1,500sq.ff.=$130. Up to2,500sq.ft =$19.5. Up to3,500sq.ft.=$260. Up to4,500sq.ff.=$325, etc. (i.e.a
baste with .4,675 sq. ft. will be charged $325)
❑Spas/Pools/Generatos:0 YesQ No
• Note thatspas/pnols/penerntars are not Included In squarefootage costs and{vill be charged $65 per Inspection.
APPLICANT'S SIGNATURI?,CRIi'1'IFICA'rioN AND AUTHORI7.ATION: Underpenally ofperjary, I berebycortlfy that l have read this application and slate that Ilia Information herein
Is correct and I swear that any Inforarat hn1 whklunay hereafter be given by Inc In hearings before the PimmIng and Zoning CUnxel55imh or the City Council for the City of texbnrg
shall bs truthful mrd correct. I agree to comply with all City reSuintlous and Stale Imus relating to the subject nnnterorthis nppllcatlon and hereby nuihmlxed representatives of the
CRy to weer tymu the xbuveaneutloned property fm' Inspections purposes. NO•re: Tho bullding official may revokeo permit un approval Issued under the provislous df 1Im2012
International Cade In cases efany false statement or misrepresentation of fact In the application or on the plans on which the pennitor approval was based. Perndl voldlfnot
stoned mlthln 100 days. Permltvoid if win kstops for loo days.
Applicant's Name (print):—`(,qfa FJ`nkn Signature: �y�V-N- -5V�, Date: I/r�/7
Inspections umst he called In before SAM on the day the Inspection Is requested. Inspection requests celled In after CAM will be scheduled for the next business day.
Inspection nature- (200) 372.2344 www.rexbxrg.org PeruetTechnlclur (200) 372.2341
pE%aUq
CITY OF
' REXBURG
r
CW
Anmrical Family community
SUBCONTRACTOR LIST
Excavation & Earthwork:
Concrete: 9,V (NARYId CO(\CV&kt, , f, v
Masonry: J
Y
Roofing: �J(� (✓ �5 OY �D�(at1
Insulation:
Drywall:
Painting: t_)Q$I5Y\
Floor Coverings: CG � PeA- Q1 `ed—
Plumbing: \W\_-e-�Y\aT Y
Heating: fyI0`,(o- OQ
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses: -2, \N g, Calefo aY�
Floor/Ceiling Joists: 1SmC WC'S� �f\Dadiati
Siding/Exterior Trim:
Other:
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
Inspection Hotime - (208) 372.2344 vv w.rexhurg.org Permit Technician -(208)372.2341 Revised 10/2016
4g¢X9uq°.Q CITY OF
�a
° REXBURG
cw—
America's Family community
Affidavit of Legal Interest
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
State of Idaho
County of t'Maadison e
I, I A��i�U<'y15�v S ✓c� C"'J
Name Address90
°
r
City U State
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, skip to B)
A. That I am the record owner of the property described on the attached, and I grant my permission to:
Name
Address
to submit the accompanying application pertaining to that property.
B. I agree to indemnify, defend and hold Rexburg City and its employees harmless from any claim or liability
resulting from any dispute as to the statements contained herein or as to the ownership of the property
which is the subject of the application.
Dated this I �l, day of / I ° G`J st 20–J-7—
Signature
Subscribed and sworn to before me the day and year first above written.
DREW THURMAN
NOTARY PUBLIC
STATE OF IDAHO
Inspection Hotline- (208) 372.2344
Notary Public of Idaho
Residing at: TD
My commission expires: OMMIS"EXPIRES:
v vv.rexhurgoig Permit Technician -(208)372.2341 Revised 10, 2016