HomeMy WebLinkAboutAPPLICATIONS - 17-00638 - 2297 W 860 S - New SFR�;O g£XBORC,' Building Safety Department
CITY o F
¢ City of Rexburg
REXBURG 35 North tat East
IW—
Arnerlca's Family Community Rexburg, Idaho 83440
PERMIT POLICIES ACKNOWLEDGMENT
The City of Rexburg Building Safety Department is determined to provide excellent customer service. In an effort 7helpunderstand the City of Rexburg Permit Policies, listed below are several policies which you are required to kno
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 proved ermit.
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
Initials tag. If the red tag is removed by anyone but a City Official, citations may be issued.
No build in may be occupied without receiving a signed Certificate of Occupancy.
L
o If abuilding is occupied without receiving a signed Certificate of Occupancy, citations maybe issued and the occupants
may be evicted.
A Certificate of Occupancy will not be issued without digital copies of the As -Built Plans.
a Itis 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.
Inttials
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
da .
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
Ink' iais 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.
o The above policies will be enforced to all, regardless if this information is passed on to them or not.
II
Applicants Name (print):
V� Signature:�t'nn__Dater
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
2d2017
www.iexbu�� li or Permit Tech niclan-(208)372.2341 /
Inspection Bovine -(208)372.2344
��;0 BBURO�o CITY OF
° REXBURG
CW-
America's Family Community
SF I011
Affidavit of Legal Interest
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
State of Idaho
County
TofnMadison
:EAY--A7' cl /p -f is
Namee' T� J• ,1piQ.ioWs/ VF`c b �ZL� /
I' Address
"V! -D
City 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 � day of d&,41: 20
Signature
Subscribed and sworn to before me the day and year first above written.
V/?uiU
Notary Publil;aldahno[[::/
DARCEY E. VALERIO ([ li�(� �� 6
NOTARY PUBLIC Residing at: 1I``yv
STATE OF IDAHO
My commission expires:
Inspection Hotline -(208)372.2344 w .rexburgm'g Permit Technician -(208)372.2341 Revised 10, 2016
F;o gEXBOR�,o CITY OF
REXBURG
Claw
AmericA Family Community
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.
Sign&ture
Printed Name
Inspection Hotline -(208)372.2344 w .rexlmrg.org
v1 4:7
Date
Permit Technician -(208)372.2341 Revisedl0/2016
;o pyxnugotQ CITY OF
�Po
r 1��i BUILDING PERMIT FORM 100
Updated] m/2015
CW
America's Family Community
BUILDING PERMIT APPLICATION
New Single Family Residence
Building Safety Department
City of Rexburg
35 North let East
Rexburg, Idaho 83440
For Office Use
Permit Number: Zoning: Application Fee Paid: 0 $500
1. Property Owner
Name: �<cilk�hvlerry"� 834f�tn
Address: b�Sfl S t 1e�D d�S%� `�{ d S� 1�' P4'k-- bJ r) L State: j Ii Zip code:
Phone: 3M- 2111.. 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?
0 Yes (Skip to #4 and complete the Homeowner's Exemption)
P(No, I am working with the homeowner
2. Applicant G
Name: SqPVA A6 at:Jolrti^ Role: (Owner, Tenant, Contractor, etc.) —
Address: City: State: Zip Code:
Phone: Email: --
Contact/Rep. Name:
3. General Contractor
Name: Sy 1^^ e Qo 'OtWrt Registration #:_. q� Exp.:
Address: City: State: Zip Code: _.
Phone: Email:
Contact/Rep. Name: Phone: Email:
:AyCL `I�—Date: 0/—� —
General Contractor Authorized Signature:
_
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�fn
Address: -OR- Lot #: Block #: '1 Subdivision:
Project Description:
• Square Feet: Building Total: JS i-1 sq. ft. • # of Water Meters: Water Meter Size:
o Main Floor:.,% & I _ sq. ft. • Fireplace(s) Being Installed? 0 Yes( No
o Additional Floors: 107(0_sq.ft. • Hydronic Heating Being installed? 0 Yeaf No
o Basement:
Finished _ sq. ft. Building Permit fees for new homes are charged based on square
Unfinished- — sq. ft. footage and the City's estimated valuation. For details on howfees
o Garage `IKV sq. ft. orecalculated, contact the Building Department. Therewillolso be
• Estimated Total Cost: $ a plan reviewfee totaling 1096 of the buildhw permitfee.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofpsdr,Y, I hereby certify that I have read this application and daze that the Information hotel. Is amort and 1 swear that any
Information which may hereafter be given by me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthNl and correct. 1 agree to comply with all City
regulationsand State laws relaHng[o [he subject matter of this application and hereby authorized representatives of the City to enter upon the above-mentioned property forresenta[lon offacHn the application oro. the plans on
Inspections purposes. NOTE: The
building official may revola, a permit on approval issued under the provisions of the 2012 International Code in cases crony false sm[ementor misre
which the permit or approval was based. Permit void anotstarted Witgna
Within 180 days. Perronvoid ifworkstops for 18800 days,
��M rvgvl 9 Si
Applicant's Name (print): ture:r—
Inspections must be called in before 8 AM on the day the inspection is requested.
�.Inspection
ti org equests called in after 8 AM will be schedule Perm tTechnicia
for the extbusn a s day. 372.2341
Inspection Hotline - (288) 372.2344
Building Safety Department
V p4AGaga, CITY OF city of Rexburg
y-13UILDINGPERMIT FDRM 130
rXBURG of 416/2016 35 North 1t1 Bast
Amedrn4FnmilyConunanIcy
Rexburg, Idaho 834.40
q'un.
BUILDING APPLICATION
New SPR Plumbing
•
p Pluntbing lzee P,altt.:
Pei'it(itNutnbel; —
1. Property Dwne • f eAl jaJs
Name: �State: Zip Code:
Address: City:
Email!
Phone:
Under. Idallo Ba11diNg Code, a homeowner Is allolved to tlo wont on theL otvn Home,
Are you a homeowner doing work on your own home'!
O Yes (Ship to 03 and complete the Homeowners Bxunption)
0 No, I am working with the homeowner t y
2, Plumbing cp�1tl'actol' lC ,w r t State License H: r�
Business: lI Ur'25 tf c ��1��`'=-1" ,o T Smti
Address; "�'rGfi � Sr, =— --
limaib 1 e'low' 1
Phone: Zat
< t • n
Contact/Rep.
Phone:
e e�
PI obitig Conhacko'r Autliorize!$1gi13EuI'e: t f lease ruvldu
Acopy ofyourstateregistrut(mf/Ilcensets required to be oil fileJldlisls f thitnneyotflrmedareworklnthyc( o ((208) 372 P'
a photo copy ofyour license, lfyoll Vile 011SID'd ffyourlicense Is oa filo, please check with tiro PerTNIt Teclndcfer by¢cah(Jn0 (208) 372-2341.
3. Project Description -OR- LotA:_IO.Blockltil.Snbdivislom.
Address:
--
Descrlptionofwm'h:—
0 New SPR Conshvctlon: —1 $ 3 -s� R
frees for new construction me charred by xqunre footnOe: UP to 1,500 srp Jt = $130 +$C.S for each addfNmrnl l,000 sq.Jt. orportlon
thereof.- 125, etc. Je a
o Up to 1,50Usq.Jt.=$130. Up to 2,500 sq.fL=$19.5. Up to 8,500sq. Jt.=$260. Up to 4,500sthfc-$"
home with 3,675 sq. ft will be chnrperl $325)
❑ Nydronic (b1 -floor) Heating:0 Yos M7,xo
qunrafootn0ecostsanritvtllbeehnrDedS65+($10xJlnfmnnljoids/aoues).
. Nota thathydronkheatln,9lsnatfacfodedbfs
APPI•ICANT•S SIGNATI ig•C131TIPICATio Ns iNh aUTI O ar•20erhe give"byme 10I eatlngs Isefom IhsYPlenol gami'Lmdagl nuusiszionrorheiu CltysCmnuill for the City of Itexbdrgu
is cat rect and lsweirthntany lufermutl n Y to 1110 901111"t or,
shall be tnabfui and nlrml. I agree to mmpiy wl0s ri'ss IilertlrUssamrpnse. NOTfin Th40WI II geakl:0 niay revofle a ILLgTI t oil Bill, oval allell rB'lled litter it `' 1 a!+IV 1bl sIor tf ee2612ift1C
city to enter upon tile nhoveanenlinned prnPolly fro I I 1
lOtern::Nm:nl Code in cascsofnny falseslelcment or ndsrepresentnenn nftutlnthe nppllantlnuoron lheplans ml Whltb tbaperniltorappr�val tuns bused. Pelvdtvoidl no
sl:eled 1110,11111b) days. Perndt Toldlfrvmicslohs fm'100 days•
S b,"Pl u _Signature:
Applicant's Name (print); -
www.rexlmr9'6l'9 Pei ndt Tuehnlcha-(200) 372.23-01
luspudlens mush becatled In hefnre n AM en t6u day ILu insypeilmt Is'regnInesied. iasyedlms ra<pmsis rnlled after U AM wlii bo scheduled for the uextbashmzs day
f ispeclln0 livable -(200)372.2344
Building Safety Department
,�PrxauaQ j CITY 01' City of Rexburg
b '- -----BUILDINGPERMITFORM ,10
n
d10/]o16 35 North 1st East
UXBUR
Gr
� Rexburg, Idaho 834.40
''., , rVnrrim's Fmnlly Covmnudry
BUILDING APPLICATION
New SFR Mechanical
For Office Use ❑ Mechanical Pee Paid
Permit N umber:. —
1. property Owner �e� � U(
Name. State: Zip code:
City:
Address: Email:
Phone:
Under Idaho Building Code, ahouleownerisallowedtodoworkonthelrown Ione.
Are you a homeowner doing work on your own home?
0 Yes (Skip to k3 and complete the Homeowner's Exemption)
❑ No, I am working with the homeowner
2. Mechanical Contractor r t ZL fjf Z J
MName;
a bill StateLicense4l: �Busiuess:oCity: Staw:;� _Zip Code:Address: Em il:._LPhone: Z( L Email: oti<f4 Phone:•Contact/"-1 nate:
Mechanical Contractor Authorized Signature:
r— — —I City J g lease provide
AcopyoJyourstateregistratton/Iicensefsrequired to Le on filefjthfsfstl/Irstttmeyouhovedmreworiahtthe Ci in Resh9)37
A photocopy ofyour license. If you are unsure ffyour license Is on f t. please check with the Permit Technician by calling (200) 3712341.
3, Project Description hiBlock #:�Subdivision: 3'Jfrl �f7=+lam- —
Address: -OR- Lot #: _.
Description ofworkt
0SPRConsuvction:_ �'63l —sq. ft.
unrefootage: Up [o $SOO sq. ft. =$130+$65for each additional 1,000 sq. jt m•
Feesfw• new construction are charged by sq
portion thereof. eta (i.e. n
o Up to 1,S00 sq. ft.=$130.Up to Z50ed$325)$195. Up to 3,500sq,ft.=$260. Up to h5o0 sq.f.=
home with 3,675 sq. ft 1
❑ Number ofrireplaces:
square%on•
otnge costs and lvlll he charged $65 per Inspecti
. Note thatfireploces are not included in
❑ 1-lydronlc Heating:
uare footnge rosts and wgt be charged and additimud $GS + (VOX ft of
Note that hydropic heating is not included in sq
APPI.ICA141%SIUNA'I'URE, CEIrl ll'ICAiienl nllo)n IIIOmry1""Ur be given by In huaringsbefotethe Plannin8andT.nuingI:ominusslonm 1o, City Coowd ror lire city or
lie'eln is correct Rod linvearthst all
ttexburg shall he trmhful And correct. I agree In mnlply o•IIh all Clty rngydalimis:eJ Stale laws IeLling to Iha soblerl maltel of lids application and hereby amlwrize[
Iils
weselfa intks of IlefthL CIL)
Lite,
oopen
tile
leCi+RSOfnllylfned propel
Ilit torIn1IPOprellottlllall of fxt Innis appThe Gd itrit ording lon ticilil ll plans ov which ticperpet OR On mtovalrPYu dluµderole
de
based. Perinitvold lino[ Warted within lea days.permitt void if w.,kstops for Igo dnyl, y I
�grIf Oon�t� Signature: ��' Uate:__ q"
Applicant's Name (print):
PermltTeclmlcbn - (2ae) 372.2341
Inspections must be called In before eAFl mr lbn d:ry the inspection Is mqu`mly.reidburg.orge tuesis gilled in sacro AM svfll b^scheduled (or the next buslnrss ay.
Inspection ifoaioe - pUB) 37Z.2344
R;o *E%tlUq� Q4 CITY O F
REXBURG
r1V
r•m �s Amerlm'sFnmily Cuuumotity
BUILDING PERMIT FORM 17-0
u,d.4,.l2Q,a
BUILDING APPLICATION
New SFR Electrical
Building Safety Department
City of Rexburg
35 North Isf East
Rexburg, Idaho 83440
r0. co
Use' "
Permit Number; iQ 4CctucalFeePT[d
1. Property 01�ga1 �,2� 1
Name;
Address: City: State: Zip Code:
Phone: Email: --
Under Idaho Building Code, a h oineowner Is allowed to do work on their Own Ilolne•
Are you a homeowner doing work on your own home?
El Yes (Skip to #3 and complete the lloneowner s Exemption)
❑ No, I and workingwith the homeowner
2. Electrical Contractor
Business: G 't, t�^t. State License +•$�� Exp.:
Address: Y �City: g r ria r State; Tt� Zip Codeyy
Phone: l�% '- 9r�" `9 SZ Email: �lun seined '.� OAt:Jco
Contact/Rep. Name: mai-hAr•.,�' o ie A Phone: Email:
-- — Date:
Blecfrical CoiifracforYiiiFliorlied Signatd'rel
A copy ofyourstateregistrationJlicense is regrfre beonfrle. f its is thefrst thneyou have done work in the City of Rexburg, please provide
a photo copy ofyola• license, ifyou are unsure' aur license is tel le, please checinvIth the Permit Technician by calibig(•200)372.2341.
3. Project Description S�MM�f.>�-o�
Address: •OR- Lot#J0 Blocic#: Sttbdivision:
Description of work: N[,u1 �- 1
E]NewSFRConstvuction:•_ �e�3� .sq. ft.
Reesforneuv construction are charged by square footage: Up to 1,500sq. f . = $130+$65 for each additional 1,000 sq. ft. or
portion thereof.
o Up to I,500sq.ft.=WO.. Up t02,500sq.ft=$195.Up to$SOOsq.ft.=$Z60. Up to 4,500sq.ft.=$325, eta (i.e.a
home with 3,675 sq. ft. ivill be charged $325)
❑ Spas/Pools/Generatm•s: ❑ Yes r"O
Note that spas/po01.c/generators are not tncloded In square footage costs and Will be charged $65per Inspection.
APPI.ICAN'I'SsfcNNrnnti,CEH'i'lricNitorl ANI) AmTtaRIYATION: Linda] PenallyotPerlary, I berebyccrtify that l havc read thl:APPI1callonandsbdn tint thebdm'mationheraht
Is correct and I ssaerrthat any Infemiatlon tvldclnuayhereafter he gluon by no 1n Ircaringsbefore the Pimmhig and YunlnFCommisstou my the City Caunco for the city orRexburg
shall be tndhhd and correct. I agree to mmplywllhl all Illtyregillatlmns And slalolmvs relating to the snbapp11<aOmulect urdlerorllds ud hereby authorized represadatives of the
City to eutec title), lire uhure menlimed property far Inspectiotls purposes. I10TE: The building official may I evoke permft un approval issued nude, the provisions of 111,2012
fnternmlmmi Code ht Coles ofauy false statement orndsrepresentallon of fact In the nptdlerdiml area NmPlams on which the permit or approval Was based. Permit vola It out
,,,ted a uldil10o days. Permit Vold if real;stops fur 100 days.
Applicant'sName(print).grA' nA�P Signature: TV lz::: ''L ate:3117
Inspeellons trust becalled ht Were 0 Ali m1ill. djty the Inspection Is requested.
d.rexbuction requests called Nafter OAht Hill be scllepem Itdulad rfla,da nneltLsiness day. 41
Inspaliou finnbe-(26N)37223d4
p4%0 Uq
CITY o I=
a
REXBURG
w
Aniedm's FumQy Connnurriy
Excavation & Earthwork:
SUBCONTRACTOR LIST
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
Concrete: C1�\j6 .,ennA C.ot\CuAt !
Masonry: )_ (j -td `h2 (e—A �/%9� e Cof1�'rnL*�n j �nr,
Roofing:
Insulation:
Floor Coverings: ce t t gA- Q Lt ed-
Heating:
Electrical:
L, -
Special Construction
(Manufacturer or Supplier)
Roof Trusses: 23
Floor/Ceiling Joists: t Sm�et l0�
Siding/Exterior Trim:
Other:
Inspection I lotline- (208) 372.2344 %mw.reAurg.org Permi[Technlcian-(208)372.2341 Revisal 10/2016