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Home My WebLink AboutAPPLICATION - 17-00770 - 144 N 5th W - Remodel - DuplexR C I TY OF REXBURG America's Family community Building Safety Department City of Rexburg 35 North 1Bt East Rexburg, Idaho 83440 MULTI -FAMILY RESIDENTIAL REMODEL 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: ❑ 3 sets of building plans (see box below) -stamped by a licensed professional ❑ 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. ❑ Electrical panel layout and calculations included with building plans. ❑ Exterior Lighting Plan including photometric layout. ❑ Digital Plans (PDF Format - can be submitted by USB, CD, or Dropbox) 191, **Copies of any Contractors' State License if not on file already. Complete the Following Forms: M__'Permit Policies Acknowledgment signed. e3'Building Permit Application signed by a registered General Contractor Ow kA -d- 4. po Lj&a - rd"Mechanical Permit Application signed by a registered Mechanical Contractor OK'Electrical Permit Application signed by a licensed Electrical Contractor [Plumbing Permit Application signed by a licensed Plumbing Contractor MIA ❑ Fire Alarm Permit Application (if applicable) signed by a registered professional Nda ❑ Fire Sprinkler Permit Application (if applicable) signed by a registered professional te' Subcontractor List filled out ❑ Affidavit of Legal Interest signed [Notification Distribution List filled out Subdivisions: If you plan to build in a subdivision please check the Rexburg Development Code for any requirements such as property setbacks, architecture board approval, etc. This information is available at httl2://rexburg.org/pages/development-code. Inspection Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised 10/2016 C I TY OF REXBURG America's }molly 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. 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 In+Hale 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. o If a building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the occupants may be 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 perform the inspection. (Example: If the electrical rough in inspection is not done and the sheetrock has been nRiale 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. 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): �d �. L.ic (�tlu 5 Signature: Date: /113 Zo/7 Inspections must be called in before 8 AM on the day the inspection Is requested. Inspection requests called in after SAM 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 rlv Americas Family Community Building Safety Department BUILDING PERMIT FORM301 City of Rexburg upaamam/zets 35 North 1Bt East BUILDING APPLICATION MFR Remodel Rexburg, Idaho 83440 For Office Use Permit Number: Application Fee: ❑ $100 1. Property Owner Name: KajR_ aurl kaifi[�i��t'auA Address: 5r= 144N. 5'I'`I.>ksF City: �krrcbw State: S4a(4 Zip Code: $3440 Phone: Z06-313-3399 Email: 2. Applicant Name: Vyle- �tt�� %awS Role: (Owner, Tenant, Contractor, etc.) Ciw.Je2 B-. / 6—JaM4v2< Address: 5119 Wa %+ 5006 N eLiL City:_ 1?aaebua�_ State: sl'aho ZipCode: 8344D Phone: Zb9-313-3399 Email: wr7h!,.as,wbyvr:cda Contact/Rep. Name: - Ljy l*- W t'(W&-,e a 3. General Contractor W6,11 41 &- b 4-JA4-rZ- UnderIdaho Building Code, a registered contractor mustWthe workfora Commercial Building. Name: Registration #: Exp.: Address: City: State: Zip Code: Phone: Email: Contact/Rep. Name: Phone: Email: General 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. 4. Project Description Address: 144 11. 51' f-J.ts� Description of Work: 6pmu .z! £xos%kot Ufa h D pl:c t Project Description: • Total cost of project -materials and labor: $ 54i ors' • Check all that apply: Er -mechanical: Cost $ 8066-� O'Electrical:Cost$ 5010o.vo 111`�P`lumbing:Cost$ S0-4`0— ❑ Fire Alarm: Cost $ ❑ Fire Sprinkler: Cost $ Note: Any contractors involved will need to fill out their respective application. Building Permitfees for MFR remodels are charged by cost The application fee applies towards the total fee. For details on how fees are calculated please check with the building department There will also be a plan review fee totaling 10% of the permit fee. 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. 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): Ll 1of7Sig Date: 17 113 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 0- Amerkw3 Family Community BUILDING PERMIT FORM 311 Urdated 10/2016 BUILDING APPLICATION Remodel 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: V"W- a..J k""& WJ IiwraS Address: 144 N. S Ot f.J", �r.� City: 74)C61ffJ,, State: itl rw Zip Code: $3q4 o Phone: 20p,-313-3345$ Email:_ tr-//,'a,rs-1-49 14,td% r 2. Mechanical Contractor Business: , n u State License #: NVC- C- 135-7 Exp.: 3131 / Address: 6119 I.J. 5eooAJ, ty: 2 —L a,¢rn_ State: T: e*ha Zip Code: 6344b Phone: 20Qa - 313'339b Email: 47 taJ, Mb$"5 A Q, ISN,/,'- 4N Contact/Rep. Name: Kyl..e_ L KEI i c,,S Phone: tae-313-33bg Email: Mechanical Contractor Authorized Signature: /G„ 4144u%Ltl�- Dater A copy ofyour state registration/license is required to be Xfile. If this is the first time you have done work in the City of Rexburg, please provide a photocopy 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: 444 0, 54u Description of work: 2 fl. was J.2,tc4,zt1�uN+,/o>y� t/.,t�,icq, CpMFerL) /o D.P/•aa OKemodel Cost: 03--w sq. ft. pt rz 14"110L • Fees for remodels are charge by cost: o First $10,000 = 2% + $60. From $10,000 to $100,000 = 1% + $260. Above $100,000=.546+$1,160. i.e. Work costing $15,000 will be charged $260 for the first $10,000 and 1 % of the remaining $5,000 = $260 + $50 = $310 total fee • There will also be a plan review fee totaling 10% of the above fee. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury, I hereby certify that l have read this application and state that the information herein Is correct and 1 swear that any information which may hereafter be given by me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct. 1 agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2012 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void ifwork stops for 180 days. Applicant's Name (print): q-6 &iJI—cp Signature: E Nf6GA/ 1/%L- Date: /Z /3 L0/7 Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM will be scheduled for the next business day. Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 C I TY OF REXBURG America's Family community BUILDING PERMIT FORM 321 Updated 1012016 BUILDING APPLICATION Remodel Electrical Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 For Office Use Permit Number: ❑ Electrical Fee Paid 1. Property Owner Name: V41� d- K 1' d4T'eI UJ.*f1I,nwS Address: 144 14. 154LJ. City: State: -Cda" Zip Code: 834¢D Phone: 20B -3f3-336$ Email: u z.),%/.'6B I AA 2 fa .eV14 2. Electrical C tractor Business: Mk- 44,..a iIm-ck)L —State Li erase#: t LE-L-ZZy3e.-Xp.: �FA;61)8 Address: -VI IV City:.5 %,o "!4 State: Zip Code: A3 Hy� Phone: 2000 - 910 - LJgO O Email: tM _ eclrt Fru t�7c wta, /. /_✓iwt Contact/Rep. Name: Ili, k[ �rc[rSa rte+ t Phone:: � 40 - a>Email: � Electrical Contractor Authorized Signature: //�� Date: Z 1-L 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 Description Address: 144f4. Sf'" 1.s� // RLN / Desscc W iptionofwork: :5-?stL' S' -taut 1 2- /a0a++P di}{0,/,��t e./$ f ,.,rim hoB.tr [.]'Remodel Cost: 3 .00 sq. ft. • Fees for remodels are charge by cost: 0 First $10,000 = 2% + $60. From $10,000 to $100,000 = 1% + $260. Above $100,000 =.5% +$1,160. i.e. Work costing $15,000 will be charged $260 for the first $10,000 and 1 % of the remaining $5,000 = $260 + $50 = $310 total • There will also be a plan review fee totaling 10% of the above fee. 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 he 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 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): K L � - fnJ dl, aL"S Signature: t/MGc(�CJ Date: 17-11J/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.rexhurg.org Permit Technician - (208) 372.2341 C IT Y OF REXBURG tn, Aniericni Family Community BUILDING PERMIT FORM 331 UpdTN to/zats BUILDING APPLICATION Remodel 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 Name: VI 41, a .I�r� W. (1ilwKs n / Address: Y44 N- 50"i:J•SA City: E±-It�/a State: -radZip Code: 63440 Phone: 200-313-354113 Email: w.%/ iA"6 y u.'. taffy P uMb"Uc 2. ontractor /I Business: D et.n+-BAlI� f �a,rwbt'n� 4- H— State License #: PIb'L 1(67-7— Exp.: 3L f / lQ Address: 611 R IAl - 5nc0 AJ - City: cA i u R State: 7V" Zip Code: 83440 Phone: 108 - 313 - 338g Email: t." 9 L4 y d r'. Ln ,ila Contact/Rep. Name: Kylti tJ)t' A.. -S Phone: ZCG-313.3309 Email:ar. Yle w.q SCJ l7fad( r. tr— PlumbingContractorAuthorizedSigna`" ��n�J�Date: /z/a/47 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 photocopy 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: 144 N- 5 th NJss � / Description of work: At- 46,145 - -"— atp/�r /+ e Lv ies S•ls cr remodel Cost: 1� 3- &V sq. ft. • Fees for remodels are charge by cost: 0 First $10,000 = 2% + $60. From $10,000 to $100,000 = 1 % + $260. Above $100,000 =.5% +$1,160. i.e. Work costing $15,000 will be charged $260 for the first $10,000 and 1 % of the remaining $5,000 = $260 + $50 = $310 total fee • There will also be a plan review fee totaling 10% of the above fee. 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 Cityto enter upon the above-mentioned property for Inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions ofthe 2012 International Code in cases of any false statement or misrepresentation of fact ln the application or on the plans on which the permit or approval was based. Permltvoldifnot started within 180 days. Permit void if work stops for 180 days. Applicant's Name (print): I(y l� 12. GJ -'I I Signature: Ali Date: IZ 15 17 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) 3 72.2 344 www.rexburg.org Permit Technician - (208) 372.2341 v aexaapc, CITY OF ° REXBURG tlr America's Family Carnrnunity SUBCONTRACTOR LIST Excavation & Earthwork: t4 / R Concrete: I.t, tJjltu4, S Masonry: 1A 11 Roofing: Ljt , a4u S I Insulation: II//( W I I GuM S t Drywall: KU 1-4L- I t� I ('Gu.,tS Painting: 6i -e, i- bi.R e. LJ r�/f t`tuw-S Floor Coverings: —T8 P Plumbing: pr's.� /e- , Heating: Pe,,A �u 7�1G?hsbilkn�v>L tev llk.t u 67 Electrical: Le, W I 1414-S I I' lI Special Construction (Manufacturer or Supplier) Roof Trusses: Floor/Ceiling Joists: Siding/Exterior Trim: Other: Fro ..t`e.�_ - -r 1d ', N Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 Inspection Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised 10/2016 C IT Y OF REXBURG knerimi Family Community Affidavit of Legal Interest Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 State of Idaho County of Madison I, ICyI-e- 5119 w - 5od6 IQC_0� Name Address city Being first duly sworn upon oath, depose and say: (If Applicant is also Owner of Record, skip to B) =AAILL.0 State 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 Z :5 LZ612 day of 20 / 7 .&AJ�G� Signature Subscribed and sworn to before me the day and year first above written. Inspection Hotline - (208) 372.2344 Notary Public of Idaho Residing at: -44)b�, —rA6S)o My commission expires: www.rexburg.org Permit Technician -(208)372.2341 Revised 10, 2016 C I TY OF REXBURG Americas Family community DISTRIBUTION LIST Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 Please provide the names and emails of anyone who should begetting automated updates for this project. Review Notes Name: Kd�a IAWi llt /A4us Name: _ J� t I -t LJ Name: Name Name: Inspection Tickets Name:—iIje- LJ 1 j 1e avkS Name: wt (It'IMA-5 Name: Name: Name: Email: wt[IhwwSK@ 6yul•eJL4 Email: KLO"l k a %77 ig cj wui " • cowl, Email: Email: Email: Email: Lot��IanWck�6yN1 C�4 Email: K t �i 0.77L� 8wta r ctsu� Email: Email: Email: Inspection Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised 10/2016 0