HomeMy WebLinkAboutAPPLICATION - 18-00042 - 1175 W Main St - Valley Wide - Storage Shedy aF�OaeF'6 CITY OF
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BUILDING PERMIT FORM 405
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BUILDING APPLICATION
Commercial Accessory Structure
Building Safety Department
City of Rexburg
35 North lit East
Rexbure. Idaho 83440
For Office Use ar�
Permit Number: l4-oOo4Z Zoning: (16G Application Fee Paid:'o-siDD
1. Property Owner 1
Name: VMrEV "211 C60T /dAfi7V>�
Address: 18-Y3 i LN)COLN City: JFzn'nK State:_. Zip Code:
Phone: 9nfi "3AU FODLi Email:
2. Applicay5 (QIUS1(70—U xir`-'
Name: /l l6%1}rffl//U 6,K) MW Role: (Owner, Tenant, ontracto etc.) L'6K Z44M!?w_
Address 7t BOX 4.7qQ City: l�MI.EY State:�2_Zip Code:_'T33?'2
Phone: 9 6 Email: '11AAn 2imw wJ liOLL;i L77w`
Contact/Rep. Name:
3. General Contractor
Underldaho Building Code, a registered contractor is required to do construction on a commercial property.
Name: liy't7 GYlinl 7i�G�11J i}d,ii iCHA,7iGLl Registratlon ri: &L p.:
Address: �0%- X7-9' City: l ;1-ILFV State: de:�? 37
Phone:1/JQ 2�,t-)� Email: M.7ftln� In
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Contact/Rep. Name: 1I.1i) TZr F,Mntm I Phone: PW 731 a'IS Email: AdIN /4$ AMU
General Contractor Authorized Signature: r% Date: / Z B
Acopy ofyourstate registration/license is required to be on file. If this is the fust timeyou have done work in the City ofgexburg, please provide
a photocopy afyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
4. Project Description
Structures less than 200square feet do notneed a building permit Structures 200 square feet or larger need a buildingpermlt and
must adhere to the setback rules of the sone in which they are built
Address: // I'S" (4) ✓YI(}f 1>?--kf3ofzL>TYJ
Project Description: S7a9CiC.rC V"A"
• Estimated Total Cost: $ y). ODO IF Square Feet of Structure: Oil sq. it
• Type of structure:
11Deck ❑ Garage/Carport Shed/Shop ❑ Other: Explain
is Check All Included in Scope of Work:
❑ Mechanical Work Cost: $ f 13 Electrical Work Cost: $ 13 Plumbing Work Cost: $/9
Now: Any contractors involved will need to fill out their respective application.
Building Permitfees falmano,ry snucmru are charged based on spire footage and Me City'sesemated valuation. For details oa howjees ate -[related,
contact the Building Department There will also be a plan magnifies, toppling 10% of the building asperafee.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperryry, l hereby notify that] have read Nis applicaton and amce that the informailnn herein
is orrM and[ swear depanyinformation which may hereafter be even by me In hearings before the Planning and Zoning Commission or the City Council forthe City of Rexburg
shall be truNPol and mrreac 1 agree m comply withal) City regulationsand Smote laws roatingtone subject matter of this application and hereby anthonzed representatives of me
Cityto enter upon the above mentioned property for inspections purposes. NOTE: The building official may revokea permit on approval issued under Ne provisions oRhe2012
International Code in cases ouny the statement or misrepre enation of fact in the application or on Ne plans on which the permit or approval was based Pennitvoidifnot
,[arced within 180 days. Permltvoid ijw
fork adopshr 180 days.
Applicant's Name (print): Yvmio (Y,d1TXb1,Y1 / Signature: kk Date: d/da
InsOe¢boas must be called in before BA Mon the day the inspection is requnand. Inspection ormew called in after 8 AM will be scheduled for the nen business day.
Inspection Nadine -(208) 322.2344 wore- bmgmg Permit Technician -[208] 372.2341