HomeMy WebLinkAboutAPPLICATION - 17-00634 - 1480 N 2nd E Suite 110 - Sally Beauty - Tenant Finish - Occupancy PermitCITY OF
REXBURG
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BUILDING PERMIT FORM 202
BUILDING APPLICATION
Commercial Tenant Improvement
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use O
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Permit Number: -W G 3 �f Application Fee:,Ki�dA
1. Property Ow er
Name: v
Address: b V ity: i State._ Zi Code: ��Z� U
Phone.'q33 Email:' 2�
2. Applic t
Name: Q'-tYr ,)&., Vsgzs ROwner Tenant, Contractor, etc.)
Address: City: State: DV. Zip Code: ' 0
Phone: L —24 \— \ Email,
Contact/Rep. Name: . >) r
3. General Contractor
Under Idaho Building Code, a re$fstered contractor must do the work for a Commercial Building.
Name: .,.c.nn.-.' o.A •\L\Qf l istratjon#: Exp.:
Address:: �� City State: Zip Code: yl� I OY
Phone: �I�� —Z1✓ — X31\O E ail:
Contact Rep. Name: Pho e: 2 - fl Email: !
General Contractor Authorized Signature: Date: tib•-��(—j�
A copy ofyour state registration/license is requi o eon . I this Is the first timeyou have done work in the City of Rexburg, please provide
a photocopy ofyour license. lfyou are unsure ifyour I ense Is on file, please check with the Permit Technician by calling (208) 372-2341.
4. Project Description
Address: I4kRn N 2(A P S�-,\\c), b
Description of Work: C) CXV
Project Description:
• Total cost of project - materials and labor: $
• Check all that apply:
❑ Mechanical: Cost $ ❑ Electrical: Cost $ ❑ Plumbing: Cost $
❑ Fire Alarm: Cost $ ❑ Fire Sprinkler: Cost $
Note: Any contractors involved will need to fill out their respective application.
• Change of Occupancy? ❑ No Cl Yes: New occupancy:
Building Permit fees for commercial construction are charged based on square footage and the City's estimated valuation. The
application fee applies toward the fee total For details on how fees are calculated, contact the Building Department. There will also be a
plan review fee totaling 10% of the building permit fee.
APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that l have read this application and state that the information herein
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 approval issued under the provisions of the 2012
International Code in cases ofany false statement or misrepresentation of fact in the applicationor on ¢plans on which the per it or approval was based. Permit void if not
started within 180 days. Permit void if work stops for 180 days. , �1
Applicant's Name (prim:3 � .moi lMQ�
Inspections must be called in before 8 AM on the day the inspection is n
Inspection Hotline - (2 08) 372.2344 1
Date: i0 /g -l7
in after 8 AM will be scheduled for the next business day.
Permit Technician - (208) 372.2341
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