HomeMy WebLinkAboutAPPLICATIONS - 17-00723 - 741 S 2275 W - New SFRCITY OF
REXBURG
Ob
Americas Family Community
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
SINGLE FAMILY RESIDENTIAL APPLICATION CHECKLIST
The following items should be completed before you submit your building permit application.
*Reasonable accommodations will be made upon request.
Submit the Following Documents:
❑ 2 sets of site plans (see Site Plan Checklist)
❑ 2 sets of building plans drawn to scale (see box to right)
❑ Foundation Plan, Floor joist Layout, Floor Plan, Roof Layout Truss Details, Sectional Views, Front, Back, and Side
Elevations, Mechanical Layout Stair Details, and any details required to illustrate special construction.
Note: All Plans and Construction must conform to IRC 2012 standards.
❑ Structural Calculations (see box to right) - stamped by a licensed Engineer Seismic Design Category - D
t.
❑ Energy Compliance Report: As per the 2012 IECC, a RESCheck is required Ground Snow - SO lbs. per sq.
Roof Snow Load - 35 lbs. per sq.
ft
(available online at www.enereycodes.gov) Wind Load - 90 MPH
❑ Digital Plans (PDF Format - can be submitted by USB, CD, or Dropbox) Frost Depth - 36"
❑ **Copies of any Contractors' State License if not on file already.
Complete the Following Forms:
❑ Site Plan Checklist completed.
❑ Permit Policies Acknowledgment signed.
❑ Property Line form signed by builder.
❑ Building Permit Application signed by a registered General Contractor.
❑ Mechanical Permit Application signed by a registered Mechanical Contractor.
❑ Electrical Permit Application signed by a registered Electrical Contractor.
❑ Plumbing Permit Application signed by a registered Plumbing Contractor.
❑ Subcontractor list completed.
❑ Homeowner's Exemption signed, if Homeowner is doing work on their own home.
❑ Affidavit of Legal Interest signed by owner, if applicant is not working directly with owner.
❑ Notifications Distribution List.
Note: Please check the Rexburg Development Code for any requirements such as property setbacks,
design board approval, etc.
This information is available at http://rexburg.org/12ages/development-code.
Inspection Hotline -(208)372.2344 w .rexburg.org Permit Technician - (208) 372.2341 Revised 2%2017
C I TY OF
REXBURG
Americas Family Community
PERMIT POLICIES ACKNOWLEDGMENT
Building Safety Department
City of Rexburg
35 North 1xt 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
Initlal: 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.
•N\A' o If a building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the occupants
v may be evicted.
Ini[lals
A Certificate of Occupancy will not be issued without digital copies of the As -Built Plans.
It is the Applicants 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.
Inftia
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 .
0 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 ON 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
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
Applicant's Name (print): Signature: !/" -- Date: I AM
Inspections must be called in before B AM on the day the inspection is requested. Inspection requests called in after a AM will be scheduled for the next business day.
Inspection Hotline -(206)372.2344 www.rexburg.org Permit Technician -(206)372.2341 Revised 2/2017
CITY OF
REXBURG
rn,
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. 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.
Signature
-Tayi�t cye njef�-
Printell Name
Date
Inspection Hotline -(208)372.2344 w .rexburg.org permit Technician -(208)372.2341 Rcvised 10/2016
CITY OF
REXBURG
(y,
Americas Family Community
BUILDING PERMIT FORM 100
up,Aw ni/2016
BUILDING PERMIT APPLICATION
New Single Family Residence
Building Safety Department
City of Rexburg
35 North Ist East
Rexburg, Idaho 83440
For Office Use
Permit Number: Zoning: Application Fee Paid: ❑ $500
1. Property Owner
Name: K'tY hrv✓ iyn�a
Address: itlivil City: 0*17w, State: 10 Zip Code:
Phone: M—,2 11Lr Email: -fmr{• 6r*hrvy hannft_!,e^
Under Idaho Building Code, a homeowner is allowed to do work on their own home.
Are you a homeowner doing work on your own home?
❑ Yes (Skip to #4 and complete the Homeowner's Exemption)
o, I am working with the homeowner
2. Applicant
Name: Sit rrt 'OLi sloyt Role: (Owner, Tenant, Contractor, etc.)
Address: City: State: Zip Code:
Phone: Email:
Contact/Rep. Name:
3. General Contractor ,q
Name: I.Mt �-
S0AWVY- Registration #: ' H e� I Exp.: I2/11/17
Address: City: State: Zip Code:
Phone: Email:
Contact/Rep. Name: Phone: Email:
General Contractor Authorized Signature: Date:
A copy ofyour state registration/license is required to be on file. if this is the first timeyou have done work in the City of Rexburg, please provide
a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
4. Project Description
Address: 1 H ( S a Zit S -OR- Lot #: _ Block #: _ Subdivision:
Project Description:
• Square Feet: Building Total:_ sq. ft. • # of Water Meters: j Water Meter Size:
o Main Floor: I%q sq. ft. • Fireplace(s) Being Installed? O Yes Ila No
o Additional Floors: sq. ft. • Hydronic Heating Being Installed? O Yes] No
o Basement:
Finished. -sq. ft. Building Permitfeesfornew homes are charged based on square
Unfinished sq. ft. footage and the City's estimated valuation. Fordetails on howfees
o Garage 4N sq. ft. are calculated, contact the Building Department There will also be
• Estimated Total Cost:$ a plan reviewfee totaling 10% of the building permitfee.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperlury, I hereby certify that I have read this application and state that the Information herein iscorrecl 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 truthful and cormcL 1 agree to comply with all City
regulations and State laws relating to the subject matter of this application and hereby audurired representatives ofthe 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 20121 aberrational 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. Permit void If not started within 180 days. Peroutwad Ifworkrtops for 180 days.
Applicant's Name (print): 7R1r0 f t11 f0A6r% Signature: -1—Azt-t- L M-1 -" Date:
Inspections must be called in before B 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
�o pExetrg�,o CITY OF
F
I
° REXBURG
ro,
America's Family Community
State of Idaho
county of Madison
Namel
re��yYj
city
p'L V\
Affidavit of Legal interest
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, skip to B)
Building Safety Department
City of Rexburg
35 North 151 East
Rexburg, Idaho 83440
d" S. LJ-UoLmshr�
Address
State
A. That I am the record owner of the property described on the attached, and 1 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 I 6e,,orr-y day of J 20
Signature
Subscribed and sworn to before me the day and year first above written.
DAFICEY E. VALERIO
NOTARY PUBI IC
STATE OF IDAHO
Inspection Hotline - (208) 372.2344
�We
0
Notary PublicWhIahoo t /
Residing at:
My commission expires: 1122��
www.rexhurg.org
Permit Technician -(208)372.2341 Revised 10, 2016
Ue p¢XOUyC
,'r ,,,a CITY OF
r
0 1�.G�y1tG BUILDING PERMIT FORM 1�0
Qv oeesua to/zeta
NnedmS Fcnnify Conunun ily
BUILDING APPLICATION
New SPR Plumbing
Building Safety Department
City of Rexburg
35 North 1gt East
Rexburg, Idaho 83440
For Oftice.Use
Permit Number: o Plumbing Fee,Paid ,
1. Property Owner
Name: �[l 1'/G'V10`1S
Address: City: State: Zip Code:
Phone: Emall:
Under Idaho Building Code, a homeowner Is allowed to Ito work on theft Civil home.
Are you a homeowner doing work on your own hone?
0 Yes (Slip to 83 and complete the Homeowner's Exemption)
❑ No, I am working with the homeowner
'L,PlumbingC itracto•
G Sta/t�e License N: p� �'� "�15 %� �� is
business: e5 cu t4 '^ xp.:
Address: `E Slate: 1 Zip Code: Cl
'
Phone: 118 5-35- /' U Hmalll 11110,91.4-011,146 4
10 a 'o 1114 '•=r CJy"aa. -e +
Contact/Rep. Name: kilel Phone: Frah:
:
Plumbing Contractor Autiioi'IzeB SignaEu2'e: Date: .3
Acopy ofyourstate regfshtttfon/kcetithis Is66flisttlmeyouhavadoneworklittireCityofltexborg,pleaseprovide
a photo copy ofyour license, lfyou are wintre Ifyourlicerse is on file, please check ivith the Pernllt rechniclot by callOtq (200) 372.2341.
3. Project Description
Address; -OR- Lot N:_Block N:—Subdivision:
Descriptionol'work: Notim lizgcf
❑ New SFR Construction: 114!1 sq. R.
• Feesfornewcolsh'uctlmuarechargedbysquarefootage:Upto1,500sq.ft.=$130+$6.5fbreach additional 1,000sq.f.orportion
thereof
o Upto 1,500sqf, 4130. Up fo 2,500.q.ft.=$19.5. Up to 3,500sq.ft.=$260. Upto4,500sq.f.-$325, etc, (10.a
home with 3,675sq. ft. will be charged $325)
❑ Hydronic (In -floor) Heating: O Yes CyNo
• Nate that liydronfc heath(q Isnot Included /it squm•efoolage costs and will be clmrged$6.5+($10 x It ofmnnifolds/xorea).
APPLICANT'S SIGNATURU,CI:RTIPICATIDN AND AUTHORIZATION; Underpenallyofporlury, I horsily cattily that I)love read this appllcnllon And slate that the information herein
Is correct And Impar lhniauy Informallnn which may hereaner he given by Ine in hearings berate ilia Planning and %mllag(Amndsslnn or Ilio City conncli for the City of IleXberg
shall Le trnlbad nnA nurecr. I HR. to to comply with all City reRnhllons and Stale Imus totaling to the subject make rof this nppllcntlon and hereby nullmrized representatives or the
City to enter upon Ilteahoveanenlinned property lm' Inspertinnspnrpnses. NOTE: The bullillugoakhd way revoke a pernOt mi approval issued under tile prnvlslmuof the 2012
huenlallonnl Code In cases ehtnyfalse statement or misrepresentation offnctin Ilia appl1cn11ml or on the plans on which the permit or Approval %vas based. PeI'mU veld If not
started wltlibi lli0 days. Peruril void lfwnrk slops for iDO days.
Applicant's Name (print): 'rale' Evellt<►` _Signature:G Date:—"1 117
Inspections mnzt ha called In before It AM on the day the Inspection Is requesicd. Inspection rmluesla called In after U AM will be scheduled for the nest business day.
Inspection Iloll!no- (200) 372.2344 snvw.resburg.org Pormit Tsdudchn- (200) 372.2341
x arxouR4 Building Safety Department
o � 7�T�CITY OF
REXBURG BUILDING PERMIT FORM 110 City of Rexburg
tti
°°" °'°n°'° 35 North 151 East
America] Anmfh• Commrmiry Rexburg, Idaho 83440
BUILDING APPLICATION
New SFR Mechanical
For Office Use
Permit Number: O Mechanical Fee Paid
1. Property Owner
Name: � te- IgireytWS
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 43 and complete the Homeowner's Exemption)
❑ No,1 ant working with the homeowner
2. Mechanical Contractorl ° U4,
Bushness: P IOVAa14J i'lY it(r i 1riaL4h4e, State License 4: 01 7� 55-7— Exp.: S j/
Address: city: Stat : .1AW Zip Code:
Phone: 201- -2-1 Em il: D Nd- ee/ 1^-
Contact/Rep. Name: 1 Phone: Small: ++
Mechanical Contractor Authorized Signature: Date: 7
Acopy ofyourstate registration/Iftensa is required lobeonffie.Ifthis Ist firsttimeyouhavedoneworkintheCityofRexburg,pleaseprovide
a photocopy ofyour license. ifyou are unsure lfyour Ifcense Is on file, please check with the PermitTechnlclan by calling (208) 372.2341.
3. Project Description
Address: T% S • .,X-15 hl • OR- Lot k: _ Block k: _ Subdivision: _
Description of work:1� 'p N'W *EA -C.
❑ SFR Construction: sq. ft.
• Feesfornew construction are charged bysquarefootage., Up to 1,500 sq.A = $130 + $65foreach additional 1,000 sq.ft. or
portion thereof.
o Up to1,500sq.ft=$130. Upto2,500sq.ft=$195. Upto3,500sq,ft.=$260. Upto4,500sq.ft. = $325 etc. (i.e.a
home with 3675 sq, ft. Ivill be charged $325)
❑ Number ofFireplaces: P
• Note thatffreepllaccesare not included Insquarefootagecosts and will becharged $65per inspection.
El Ilydrollic Heating: burr-
• Note that hydronlc heating Is not Included in square footage costs and will he charged and additional $65 s ($10 x k of
manifolds/zones)
APPLICANTS SIGNAT' URF, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, i hereby certify that i have read this application and state that the Information
herein is correct and I swear that any Information which may hereafter begiven by me In hearings before the Planning and 7m inggCommission or the City Council for the City of
Rexburg hall be truthful and correct. I agree to comply with all City regulations and Stale laws rclatingto the subject matter of ills eppileatfon and hereby authorized
representatives ofthe City to enter upon the above-mentioned property for Inspections purposes. NOTE: The bulldlngomclal may revoke a permit on approval Issued under the
provisions of the 20121aberrational 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 nal started within 180 days. Permit void If work stops for 180 days.
Applicant's Name (print): !T—a:o- if t* Y1ioy Signature: �A"g `�"� Date: 2a 1
Inspections must be called In before B AM on the day the Inspection Is requested. Inspection requests called In after BAM will be scheduled for the next business day.
Inspection ilotllne - (20B) 372.2344 www.rexburg.org PermitTecbnklan - (208) 372.2341
CITY OF
IMMURG
Coil—
An rld3Fnmfly0a uufly
BUILDING PERMIT FORM 120
uemve sapasa
BUILDING APPLICATION
New SFR Electrical
Building Safety Department
City of Rexburg
35 North let East
Rexburg, Idaho 83440
ForOflIce Use
Permit Number: - - - - ❑ Electrical Fee Paid
1. Property Own r
Name; Lt 10limiatS
Address: City: State: Zip Cade: _—
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)
❑ No, I ant working with the homeowner
2. Electrical Contractor
Business: SVAe Eki14t #IAC_ State License#: QIS4PA EXP.:
Address; V.D. 96Y /Ila __ City: ?yri a State: T-N_ZipCode: F33yy3
Phone; — - Email: 4s1jw C,.41. -e dD FW .i.CA.-3l4
Contact/Rep. Name: Phone; Email:
Electrical Cotltrictor Autlioi lied Slgliafurei Date:
A copy ofyourstate reglstraton/license is require be on flle. f ds is Nreflrst thneyou have done work fn the City offlexbnrg, please provide
a photo copy ofyourlicense. lfyouare unsure l or license Is onflle, please check ivith the Permit Technician by calling (208) 3724341,
3. Project Description
Address: 1 KI S i.1T W . OR- Lot #: _ Block it: _ Subdivision:
Description of work; New tt! 4_4t
❑ New SFR Construction: . 11-1.A sq. R.
I Feesfornew construction are charged by squalefootage: Up to 1,500 sq.ft. = $130 + $65for each additional 1,000 sq.ft. or
portion thereof.
o Up to 1,500sq.ft.=$130. Up to2,500sq.ft=$195. Up to 3,500sq.ft.=$260. Up to 4, 500sq.ft.=$325, etc. (I.e.a
borne Filth 3,675 sq. f . will be charged $325)
❑ Spas/Pools/Generators: ❑ Yes WNo
e Note thatspos/pooLr/generatorsarenotbrciudedhlsquarefootogecostsandwillbecharged$65pet,Inspection.
APPLICAN'rSSHINATURIi,CEIfI'IPICA'I'[ON AND AUTHORIZATION: Under penally ofperlury, I herellycertlfy that l have read this application and slate that the lnfnrmatlon hereto
Is correct and 1 swcarthat any Information which may hereafter be given by me in hearhigs before the Planniug mid Zoning Commission or the City Council for the City of ltoyburg
shall be trmlhhd mid correct. l agree to caunply with all City regulations and State lacus totaling to the subject ma0erat tills appllcallon and hereby authorized representatives of the
City to mnvi upon the nbove-mmUloned properly for Inspections purposes. NOTE: The bulldingof0cial any rovoke a Formula, approved Issued under the provisions of the 2012
International Code In cases ofanyhlse statement or misrepresentatlon of fact In theappllcallon aron the plans on which the permit or approval was based. 1'eunit void If not
starteA within too days. permit void Ifwet kstops for 100 days.
AppiicanesName(print): ' efir&60!!Sgr Signature: :met- ��t3i—� Dater
Inspections nluslbe called In before DAN on lila day the Inspection Is Iequeslol, [inspection request, called hi after O AM will beschednled far tie next buslness day.
Inspection Ilmline-(200)372.2344 wwimeldergorg permit Technician -(200)372.2341
Excavation &
CITY OF
REXBURG
ryr
AmerlcaS rami y Conunuu0y
SUBCONTRACTOR LIST
Concrete: 9)Q Coo we;k , ±j1 t,
Masonry:
Roofing: ZM C, Vy QS k l o/�f �O f llar�
Insulation:
Drywall:
Painting: \Jw\o-C- voe I�Y\
Floor Coverings:CG-Ue� O\ `eok-
Plumbing:
Heating:
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses: �at�Co�ov�
Floor/Ceiling Joists: 11 1L C't } Co r toaL5-& N
Siding/Exterior Trim:
Other:
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
Vl
Inspectlonliotline-(208)372.2344 %e vxexburgorg Permlt Technician -(208)372.2341 Revised 10/2016