HomeMy WebLinkAboutAPPLICATIONS - 17-00719 - 407 S 3rd E - Addition4
Q4E%aU4C,
F; .a clTx OF
°., RE)C 7 RG BUILDING PERMIT FORM 102
016 upda,:a,o/zms
America's Family Community
BUILDING APPLICATION
Single Family Residence Addition
Building Safety Department
City of Rexburg
35 North lst East
Rexburg, Idaho 83440
For Office Use
Permit Number: Zoning: Application Fee Paid: O $100
1. Property Owner' I /�G / ('� N
Name: A � S- W 7i{% S [
Address: 9 rOl City: �u� State: _,E6— Zip Code: C!3k�4
Phone: 9 -7b I V9 Email:0AC S PK 0_vl • %✓�l
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?
9/Yes (Skip to #4 and complete the Homeowner's Exemption)
❑ No, I am a contractor working for the homeowner
2. Applicant
Name: Role: (Owner, Tenant, Contractor, etc.)
Address: City: State: Zip Code:
Phone: Email:
Contact/Rep. Name:
3. General Contractor
Name: Registration #: Exp.:
Address: City: State: Zip Code:
Phone: Email:
Contact/Rep. Name: Phone: Email:
General Contractor Authorized Signature: 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 Des
t�criptige'G
Project Description:
• Square Feet of Addition:�% $T sq. ft.
• Estimated Total Cost: $ Oi -
• Fireplace(s) Being Installed?'D Yes No
Building Permit fees for new homes are charged based on square footage and the City's estimated valuation. For details on how fees are calculated, contact
the Building Department. There will also be a plan review fee totaling 10% of the building permittee.
APPLICANT'S 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 I 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 theprovisions ofthe 2012
International Code in cases of any 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 if work stops for 180 days.
--VApplicanes Name (print): L199 Signature:_y� tP�DUT�'1 `� 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
CITY OF
REXBURG
cy�
Amerirai Family Community
BUILDING PERMIT FORM 112
nad.loi ro�mts
BUILDING APPLICATION
Addition SFR Mechanical
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
For Office Use
Permit Number: ❑ Mechanical Fee Paid
1. Property Owner
Name: OO &I NCPI,f)OTTA 77
Address: C-)-7 .S 1,0 , City: Ag F State: J- Zip Code:
Phone: 2D % h % R Email: q ✓f C )rj 4n o p , COM
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)
Cl No, I am working with the homeowner
2. Mechanical Contractor D
Business: SA M� A S �n L State License #: Exp.:
Address: City: State: Zip Code:
Phone: Email:
Contact/Rep. Name: Phone: Email:
Mechanical Contractor Authorized Signature: Date:
A copy ofyourstate registration/license is required to be on file. If this is the first time you 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.
3. Project Description
Address:
Description of work:
❑ New SFR Construction: sq. ft.
• Fees for additions are charged by square footage: Up to 1,500 sq. ft. = $130 +$65for each additional 1,000 sq. Jt orportion
thereof.
o Up to 1,500 sq. ft. = $130. Up to Z,500 sq. fl. = $195. Up to 3,500 sq. fL = $260. Up to 4,500 sq. fL = $325, etc. (i.e. a
home with 3,675 sq.ft, will be charged $325)
❑ Number of Fireplaces:
• Note thatfireplaces are not included in square footage costs and will be charged $65 per inspection.
APPLICANT'S 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 I 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 of any 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 ifwork stops for 180 days.
Applicant's Name (print): J g �l ) ^ FILA 1)Vt Signature: Jwu � Date: X f7 tel%
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) 3 72.2 341
CITY OF
REXBURG
America's Family Community
BUILDING PERMIT FORM 122
uIM, ro/ears
BUILDING APPLICATION
Addition SFR Electrical
Building Safety Department
City of Rexburg
35 North lst East
Rexburg, Idaho 83440
For Office Use
Permit Number: 0 Electrical Fee Paid
1. Property Owner
Name: L �
Address i 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?
0 Yes (Skip to #3 and complete the Homeowner's Exemption)
0 No, I am working with the homeowner
2. Electrical C ntractor _ �t �y
Business: 1 ✓ Cj l r�lf�-VI C- State License #: e C 7 % /Ex
p.:
Address: III PO, CC—MTte City: rCXsup:;� State: --r—> Zip Code: d
Phone: Email: r m4,11- CO %,
Contact/Rep. Name: n-76—r?-ISCI/14J Phone:' 0 19% ail:
Electrical Contractor Authorized Signature: 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.
3. Project Descri tion
Address: LLQ � - ,3,d C -OR- Lot #: _ Block #: _ Subdivision:
Description of work: � f
B/
%
New SFR Construction: T sq. ft.
• Feesfor additions are charged bysquarefootage: Up to 1,500sq.ft = $130 + $65foreach additional 1,000 sq.ft. orportion
thereof.
o Up to 1,500 sq. f = $130. Up to 2,500 sq. ft. = $195. Up to 3,500 sq,ft. t. = $260. Up to 4,500 sq. ft. = $325, etc. (i.e. a
home with 3,675 sq. ft. will be charged $325)
0 Spas/Pools/Generators: 0 Yes 0 No
• Note that spas/pools/generators are not included in square footage costs and will be charged $65 per inspection.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, l hereby certify that l 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 Zoning Commission or the City Council for the City of Rexburg
shall be truthful and correct. 1 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 of any 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 if work stops for 180 days.
Applicant's Name (print): N6-POWTP Signature: — �sLM 4oy ,= Date: 4di I% �)60
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) 3 72.2 341
CITY OF
REXBURG
Americas Family Community
HOMEOWNER'S EXEMPTION
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
As of January 1, 2006, the City of Rexburg can no longer sell permits without having a copy of your State
registration number or your exemption from the State registration. Please fill out this form showing your
exemption and send it with your permit application.
Idaho State Statute allows a homeowner to do work on their own residence:
An owner performing construction on the owner's personal residential real property, whether or not occupied by
the owner, provided however, this exemption shall not apply to an owner who is otherwise regulated by this chapter
who constructs a building, residence or other improvement on the owner's property with the intention and for the
purpose of promptly selling the improved property, unless the owner has continuously occupied the property as the
owner's primary residence for not less than twelve (12) months prior to the sale of such property;
Title 54, Chapter 52, Subsection (2)
1 hereby certify that the above information is true and correct to the best of my knowledge.
-, �W kwaz� // / 7 ) -7
SignatuH Date
i A 9 J) ' 0C�LLV/?714
Print Name
Permit Technician — (208) 372.2341 ..rexburg.org Revised 10/2016
OQ gExBUgC
CITY OF
1EXBURG BUILDING PERMIT FORM 13 2
upaaa to/zots
OW
Amerfm's Family Community
BUILDING APPLICATION
New SFR Plumbing
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use
Permit Number: ❑ Plumbing Fee Paid
1. Property Owner p7 fir—r D
Name: "S,qT S �%lLl7�_) wlipT)4
Address: City: State: Zip Code:
Phone: Email:
Under Idaho Building Code, a homeowner is allowed to do work on their own home.
Are youa }yomeowner doing work on your own home?
Yes (Skip to #3 and complete the Homeowner's Exemption)
❑ No, I am working with the homeowner
2. Plumbing Contractor
Business: State License #: Exp.:
Address: City: State: Zip Code:
Phone: Email:
Contact/Rep. Name: Phone: Email:
Plumbing Contractor Authorized Signature: 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. lfyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
3. Project Description
Address: -OR- Lot #: _ Block #: _ Subdivision:
Description of work:
Oew SFR Construction: _ sq. ft.
Feesfor additions are charged by squarefootage: Up to 1,500 sq.)t.=$130+$65for each additional 1,000 sq.Jt orportion thereof.
0 Up to 1,500 sq. fh = $130. Up to 2,500 sq. f t. = $195. Up to 3,500 sq. ft. = $260. Up to 4,500 sq. ft. = $325, etc. (i.e. a
home with 3,675sq. ft. will be charged $325)
❑ Hydronic (In -floor) Heating: O Yes P(No
• Note that hydronic heating is not included in square footage costs and will be charged $65 extra.
APPLICANT'S 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 I 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 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 application or on the plans on which the permit or approval was based. Permnvoidifoot
started within 180 days. Permit void if work stops for 180 days.
Applicant's Name (print): � Signature: Jlq Lmr' 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
CITY OF
REXBURG
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 permit.
J' I o Building without the pink building permit signed by the Building Inspector will result in double fees to be
li assessed and the project to be red tagged. if your project is red tagged, halting all construction, only a City
Initials Official may remove the red tag. If the red tag is removed by anyone but a City Official, citations may be
issued.
No building may be occupied without receiving a signed Certificate of Occupancy.
J� o If a building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the
occupants maybe evicted.
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 If an inspection is not done, the inspector may require any measures to be taken to allow him to correctly
U perform the inspection. (Example: If the electrical rough in inspection is not done and the sheetrock has been
Initials put up, the inspector may require the sheetrock to 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. These documents must be signed by the appropriate authorities from
the City of Rexburg. Any approvals can be verified by calling (208) 372-2341.
o Even if you hear from an inspector that'you're good to go', ultimately if you do not have a Building Permit or
Certificate of Occupancy, the above policies will be enforced.
Initials
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.
JI' o The above policies will be enforced to all, regardless if this information is passed on to them or not.
Initials
Applicant's Name (print):V A) I � e7 Signature: ! � wev 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 10/2016
CITY OF
REXBURG
Americas 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. If you want to request a copy of your lot, see the front counter at the Community
Development Department.
I have read and understand the above requirements.
c LA i �
Signature—T
"U hu -y J
Printed Kame
U013
Date
Inspection Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised 10/2016