HomeMy WebLinkAboutAPPLICATION - 17-00548 - 2176 Summerfield Ln - New SFRCITY OF
REXBURG
nv
America's 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
approved ermit.
o Building without the pink building permit signed by the Building Inspector will result in double fees to be assessed and
11 the project to be red tagged. If your project is red tagged, halting all construction, only a City Official may remove the red
inieials tag. If the red tag is removed by anyone but a City Official, citations may be issued.
No buildin maybe occupied without receiving a signed Certificate of Occupancy.
�/ o If a building is occupied without receiving a signed Certificate of Occupancy, citations maybe issued and the occupants
1 may be evicted.
Initials
A Certificate of Occupancy will not be issued without digital copies of the As -Built Plans.
/0 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.
Initials
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/bund on the inspection sequence page in this packet If an inspection is not done, the
f1i 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 begirt Quell ,y 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
1 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.
The above policies will be enforced to all, regardless if this information is passed on to them or not.
�n
Applicant's Name (print)l� tvQ 17yh Signature: Date:
Inspections must be called in before 8 AM an 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
C i TY OF Building Safety Department
oN o 1 EXB l RG City of Rexburg
C 35 North 1st East
America's Family community Rexburg, Idaho 83440
PROPERTY LINES
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.
,a K 41y,- --__ 9/S-/1-7
Signature Date
'rare Fyonaa,
Printed Name
Inspection Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised 10/2016
CITY OF
REXBURG
America's Family Community
Building Safety Department
BUILDING PERMIT FORM100 City of Rexburg
nadated 1012016 35 North 1st East
BUILDING PERMIT APPLICATION
New Single Family Residence
Rexburg, Idaho 83440
For Office Use
Permit Number: Zoning:
Application Fee Paid: ❑ $500
1. Property Ow (�
�*I"
Name: "Vw(
Address: i5q
City: hJr!;l State: 1 0 Zip Code: 61"4Z)
Phone:
Email:-��ttn�alsast�hn=f�� .cart.-�
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 #4 and complete the Homeowner's Exemption)
I�No, I am working with the homeowner
2. Applicant
Name: &d INR- e4 .cb air_
Role: (Owner, Tenant, Contractor, etc.)
Address:
City: State: Zip Code:
Phone:
Email:
Contact/Rep. Name:
3. General Contractor
Name: C-4 r'sry Cis abzr`c
Registration #: Lf Sq Exp.: 17-131l1-7
Address:
City: State: Zip Code:
Phone:
Email:
Contact/Rep. Name:
Phone: Email:
General Contractor Authorized Signature: ��Y't
rva1_ Date:
A copy ofyour state registration/license is required to be on file. If this is the first tinleyou 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: al -1 It Su Mm er 9 & LeleN -OR-
e
Lot #: Imo" Block #: JL Subdivision: M rn a(-)'�e y
Project Description:
• Square Feet: Building Total: k040 sq. ft.
• # of Water Meters: I Water Meter Size:
o Main Floor:03(e sq. ft.
• Fireplace(s) Being Installed? ❑ Yes �r No
o Additional Floors: I ?7!n sq. ft.
• Hydronic Heating Being Installed? ❑ Yes IX No
o Basement:
Finished sq. ft.
Building Permitfeesfor new homes are charged based on square
Unfinished sq. ft.
k 00
footage and the City's estimated valuation. For details on howfees
o Garage sq.ft.
are calculated, contact the Building Department There will also be
• Estimated Total Cost: $
a plan review fee totaling 1095 of the building permitfee.
APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, l hereby certify that have read this application and state that the information herein is correct and l 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 withall City
regulations and State laws relating to the subject manor of this application and hereby authorized representatives of the City to enter upon the above-mentioned property for inspections purpoma NOTE: The
building official may revoke a permit on approval Issued under the provisions of the 2012 International Cade in cases ofany 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 leo days. Permit void ifwork stops for 180 days.
Applicant's Name (print):�G1r� FVte Signature: �� 7� Date: 7
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
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CITY O P
o nn rURG BUILDINGPBRMIA,FORM 130
nv
AmerlmS Fmnlly Conununrty
BUILDING APPLICATION
New SFR Plumbing
Building Safety Department
City of Rexburg
35 North 1st Bast
Rexburg, Idaho 83440
For Office Use - ...
Permit Number: b Plumbing pee Paid ..
1. Property Owner
Name; Ski_ QfeJi',-t5
Address: City: State: Zip Code:
Phone: En3ail: —_—.
Under Idaho Building Code, a homeotvneris allowed to do work on their otvn home,
Are you a homeowner doing wm•Ic on you I- own home?
❑ Yes (Skip to 43 and complete the Homeowner's Exemption)
0 No, I am working with the homeowner
2. Phunbing C ntractor AI 1
Business: 01,e5 6,� ,` SGL_ State License lt: Pt P1 _e -1I S f %Hxp.:
Address: `E t..
Z- _ r %e ad . ;/ ,-n,---i State: -1 Zip Code: /F %Cl
7
Phone: o6 533- ifloo Email: /Wed,j'","-r E aA"C. ec�'
Contact/Rep.Name: nci 0,r 01de Phone: HMA1:
Plrimliilg Contractor Authorized Signature: Date: .3 l
A copy ofyour statere,9lstraNmr/license is required to eauple.Ifthls ls6Afll timeyau have done work In the City of Rexburg, please provide
a photo copy ofyour license. Ifyou are assure Ifyom' license Is on f/le, please check with the penult Technlckul by calling (200) 372.1341.
3. Project Description
Address: 21111 Stlmm-(�l,Q Im -OR- Lot 0: Y Subdivision: S✓mmo(�<P�
Description of work: t ln, M- eve k
r3 New SPR Construction: '"'-t 5 sq. ft.
Pees for new construction are charged by square footage: Up to 1,500sq. ft. = $130 + $65for each additional 1,000 sq.ft. . or portion
thereof.
o Up to 1,500 sq.f.=$130. Up to 2,500 sq. f,=$195. Up to 3,500 sq. ft. =$260. Up to 4,500 sq.ft.=$325, etc, (l.an
home with 3,675 sq. ft, will be charged$325)
❑ Hydronlc (In -Roar) Heating: O Yes FYNo
Note that hydrDilk heating is not included In sgrmre footage casts and will be charged $6.5+ ($10 x71 of nianlfolds/7ones).
APPLICANT'S SIGNATURC, CERTIFICATION AND AUTIIORi2ATION: Under penally ofpor)ury, l harebyMory that l have read this application And state that the Information hereln
Is correct slid I swan and any informntlmn which may hemmer be given by me In hearings before the Malting And'LailhigCammisslon or the City Council for the City of Itexbmg
shall he l othtnl And correct. I ngme to cntnply with all City regulal Ions and Slate Imus relating to Iia stlh)ect um0.er of tits Application And horchy Authorized ropirosonlalives of the
City to ever upon the nboveaneltln ed property fmhnspecltons parposm NOTE: The building oalclal may revogea pe'nat ou approval lssnehmder the provisions of the 2012
Inlernatlanal Cada In cases ninny fnlso slalenyed or misrepresmantlon of fact In Ibe application Or on the Penn on which the porn0tor Approval was based. Pei Alit Vold If not
stared wllbhn 11111 days. Penult void If wnrh stops for 180 days.
Applicant's Name (prhlt)I —rairq o —signature: ��V'� Date;_T�S/[j
Iuspechlans nmsl be called In before O Ali ml the day hie Inspectlmt Is retltlestad. inspection tactless, Called In After V Ali will he schedtded toy the next business day.
Inspuctlon llalllne-(200)372.2344 www1oldn reorg Pariah Technician -(200) 372.2341
CITT OF
REXBURG
cvv
Amn,1 3 Family Community
Building Safety Department
BUILDING PERMIT FORM110 City of Rexburg
apdradtoltata 35 North IsCEast
BUILDING APPLICATION
New SFR Mechanical
Rexburg, Idaho 83440
For Office Use
Permit Number: ❑ Mechanical Fee Paid
1. Proert caner
I
y 1-b 5-V �' -a-
Name,
: �-lY
Addres City:yrb•�r-'j�State: 1 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 Homeowner's Exemption)
13,b1o, I am working with the homeowner
2. Mechan((ical ContractoruL
Business: of i t. b fState License #: 017-:5-5-z- Exp.:
Address: 7,90 City: Stat : -Wi-7_ Zip Code:
Phone: 21- 7-1 Em il: o ct.- 4_- ♦ Ah e- +
Contact/Rep. Name: Ch4a I Phone: • 5 - 7 Email:c ,+
Mechanical Contractor Authorized Signature: r ^ ~'1 Date;-
Acopy ofyourstatereglstmtion/lIcense is required to be on/tie. If this is th first ttmeyou have done work In the 01yofRexburg, pleaseprovide
a photo copy ofyour license. Ifyou are unsure Ifyour license Is on file, please check with the Penult Technician by calling (208) 372-2341.
3. Project Description
Address, I0(c5orhrvlet{ifed Gr OR- Lot#: 41Block#:L Subdivision: - w/Vh hd-2SP�
Description of work: lec,d tj-b ni e
❑ SFR Construction: V-4 D sq. ft.
e 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 4,500 sq. ft. = $325, etc. (i.e. a
home with 3,675 sq. Jt will be charged $325)
❑ Number of Fireplaces:
a Note thatfireplaces are not Included in squarefootage costs and will be charged $65 per Inspection.
❑ Hydronic Heating: -&-I—
e Note that hydronk It eating Is not Included In squorefootage costs and will be charged and additional $65 + (V 0 x # of
manifolds/zones)
APPI.ICAN3"S SIGNATURE, CERTIFICAl iON 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 Information which may hereafter be given by me In hearings before the Planning and Zo iingCommission or the City Council for the City of
Rexburg shall be truthful and correct. 1 agree to comply with all City regulations and Slate laws relating to thesubject matter ortldi applicatlon and hereby authorized
I epresentatives of the City to enter upon the above-mentioned property for Inspections purposes. NOTE: The building official may revoke permit on approval Issued under the
provisions of the 2012 International Code In cases ofmry falsestatement 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 Ifwork stops for 180 days.
Applicant's Name (print): r� ✓pn5 Signature: 7;-- Dater
Inspections must be called fn 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 lion In. -(208)372.2344 mm.rexburg.org Permit Techn lcian-(208)372.2341
°taexOUAq
CITY OF
J T:
REXcw
w
A n¢r(ml Fnmil y Cunnrnmiry
BUILDING PERMIT FORM 120
usa,adolum
BUILDING APPLICATION
New SFR Electrical
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
Ffii� Office [jse
PermitNumber: ` ❑ Electrical Fee Paid
1. Property Owner
Name: G)�C f'�e f t D -s
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 03 and complete the Homeowner's Exemption)
o, I am working with the homeowner
2, Electrical Contractor
Business: �vidr— re/ Ck�J4z eft State License#: .,--Exp.:
Address: b r Y 1l6 City: F! I Pill F- State: Zip Code: f33yy
Phone: 2^9
Contact/Rep. Name: a Phone: Small:
Elecfncal Coiitractor Authoi'iied Sigliatuiei Date:
A copy ofymn•state registration/license is require be onfile, ffe ds Isthefrst timeyou have done work In the City of Rexburg, please provide
a photo copy ofyour license. Ifyou are unsure tIoo• license Is on f 1e, please check with the Penult Technician by calfirw (200) 372.2341.
3. Project Description
Address: cWUSJmmc(F4e.QL✓I -OR- Lot#:Block#:fL Subdivision:S� -�I9'
Description of work: Wei. j- tlzncx
❑ New SFR Construction: a- o-0 sq. ft.
I peesfornew construction are charged bysquarefootage: Up to 1,500sq.R=$130+$65for each additlonall,000 sq.Jt. or
portion thereof.
o Upto 1,500sq.Jt.=$130. Up to2,500sq.f.=$195.Upto3,500sq.)t.=$26a Up to4,500sq./t.=$325, etc. (Le,a
home with 3,675 sq. ft. wlll be charged $325)
❑ Spas/Pools/Generators: ❑ Yes MAO
e Note thatspns/pnolr/generators are not included In squarefootage costs and will be charged $65 per Inspection.
APPI.ICAN'I"S SIGNATURO,CF.IVFIFICAT'ION AND AUTHORIZATION: andorpenalty orperjury, I hereby certify that l have read this application and slate that the Information hereln
Is correct slid I swear that any Infonnalimnvblch inay hereafter be given by me In hearings before the Planning mut Zoning Co n nisslou or the City council for the City of Rexburg
shall be tndhfnl and correct. I agree to comply tvlth all City regulations and State laws totaling to the subject renterofflils application and Ill authorized representatives of the
city to cull upon (he above-uemdlnned properly far Inspections purposes. NOTE: The building official may, revokes pennilon approval Issued under the provisions of tha2012
Inleri allonel Code In cases of any false statement or misrepresentitle n of fact In the application or an the plans on which lite permit lir approval was based. Penult Void If not
slatted within 100 days. Permit veld if work stops for Igo days.
Applicant's Name (print): `t Pn a Signature: Date:
�/ F_ 7
Inspections umst be called In before 8 AN oil the day the hsspeclion is Ieupnesled. Inspection requests called In after a AM evil[ be scheduled for lire next business day.
Iinpecaon Noaine- (208) 972.2844 www.rexburg.org PermltTechnician - (208) 372.2341
CITY OF
REXBURG
America's Family Community
SUBCONTRACTOR LIST
Excavation & Earthwork:
Concrete: 9)V (,Q Ana Concy-&k, k 0 /,
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
iV)
Masonry:Z�1'i�l�l�i�[.�.�►7aZ����Z�GTL>l��
Roofing:
►
pt
Insulation:
Drywall:
Painting: n(N\ne t)4eSly\
Floor Coverings: Ce—� &A—
Plumbing:
Heating:
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses: t)v) Galio-,�NaV',
Floor/Ceiling Joists: _ lSmC WC'S� COctOafLl�
Siding/Exterior Trim:
Other:
Inspection Hotline—(208)372.2344 w Y.rexburgorg permit Technician—(208)372.2341 Revised 10/2016
OQ pEXOUgC
is CITY OF
REXBURG
CW-
Amrricak Fa tyCommunity
Affidavit of Legal Interest
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
State of Idaho
County of Madison 1L
I 'rGf rct Evense-yi
Name Address
i`-v�Ic�OV rS
city
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, skip to B)
State
Ib
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
day of /� ,S "$ t— 20 0
Signature
Subscribed and sworn to before me the day and year first above written.
DREW THUR(AAN
NOTARY PUBLIC
STATE OF IDAHO
Inspection Hotline- (208) 372.2344
Notary Public of Idaho
Residing at: c(ca .\ 1=0,Kk-, TD
My commission expires: W COMMSSION EXPIRES:
Apo 11, 220
www. rexbm'g.o1'g Permit Techuiclan-(208)372.2341 Reviscd 10, 2016