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Home My WebLink AboutAPPLICATION - 13-00093 - 1103 Greenside Loop - SFRBuildi..g Safety Department _ titre.=. ° City of Rexburg � °s CITY OF RMURG 35N P' E Phone: 208.3]2.2326 Rexburg, ID 83440 www.rexburg.org Fox: 208.359.3022 Minim's F.rl Community Office Hours: Monday -Friday 8:00=-4:00pm Single Family Residential Pre Construction Checklist Seismic Design Category — D Roof Snow Load — 35 lbs. per sq. ft. Ground Snow— 50 lbs. per sq. ft. Wind Load— a MPH Frost Depth — 36" The following items abould be completed you.rubmityow bmldtngpetmit appheation. Completion ofa Building permit Application: You may print this application from our website AMY-IMUM0 or pick up a copy at the City Hall Annex Building (address above). For �Residential Permits: (the following is required to be submitted before the Application can be approved) /" 2 sets of site plans and 2 sets of building plans (must be drawn to scale) -Plans must include foundation plan, floor joist layout, floor plan, roof layout, sectional views, front, back, and side elevations, mechanical layout, stair details and any details required to illustrate special construction. Energy Compliance Report The State of Idaho has adopted the International Energy Conservation Code (IECC). A Compliance Review must be completed and submitted (the xescheck software is available online at www en .°v ods v). �. Page 2 of the Application must include the Idaho Contractor's Registration Number must be completed and siga see Page 10. or the exemption form Y Page 5 of the Application must be completed and ign d bby y ut Plumb . p( Page 6 of the Application must be completed and sped by yes Mechanical contractor. * Page 8 of the Application must be completed and tgned b y y m,Fle �c ( Home owner: please complete page 6 of the application if you will be doing your own electrical work. ryt( Truss details including engineered floor joists are required. V, Property Line form needs to be signed by the budder or owner, see Page 4. 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 from the Planning & Zoning Department at the Annex Building located at 19 East Main. New Residential Homes If your building permit is for a new home, you will need rhe parcel number (a parcel number it the county'r properly identifrcation bib recognizes -plot of land! and a new physical address will be issued. If you do not know the parcel number and cannot find a record of it, please bring the name of the subdivision, phase, and the lot and block numbers. Tete on t location is vital to a sur comet addressm . Remodels If you are considering a remodel, a COQ of the bid or estimate for the remodel must be submitted with the Permit Application. • 2 sets of Plans are required (may need IECC Review). • Additions are the same requirements as new construction. oaasxsvpo �a �o CITY OF '\ Please Complete ale Entire Application! IE the question does not apply fill in NA for non.pphmble Ametlm's /'madly Community RESIDENTIAL BUILDING PERMIT APPLICATION 35 N "' E, REXBURG, ID 83440 208-372-2326 PARCEL NUMBER: (R�� (We will provide this for you) SUBDIVISION: OCZ �Y 1� 5�'A GS UNITY# I BLOCK# I LOT# (Addvessing is based on the information - must be accurate) Dwelling Units: Parcel Acres: PHONE PROPERTY PHONE #: Home ( ) Work ( ) Cell OWNER MAILING ADDRESS: Slq Vts n CITY: EMAIL ✓1M� (yre>•. .. _—STATE:,1 ZIP:A,�y�r� MArpyloddCoA APPLICANT (If other than owner) (Applicant if other than owner, a statement authorizing applicant to act n agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS �...... STATE;_ ZIP EMAIL FI PHONE #: Home ( ) Work ( ) Cell CONTRACTOR MAILING ADDR PHONE #: Home ( )_ Work ( )_3�0_ � _ � Cell ( ) EMAIL --FAX IDAHO REGISTRATION # & EXP. DATE3�� How many buildings are lorared on this nmme.wa Did you recently pamhue this property? Ne Ye Uyes, list previous owmses name) Is dais a lot spud® YES (Please bring copy of new legal description of property) PROPOSED USE: �'i_10 :y ZZK4'1V (i.e., Single Family Renue , soonernasmsy, Apartments,itemood, Gavage, Commi dal, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of p,iury, I hereby certify that I have read this application and state that the information herein is correct and I swear that any infomemon which may hereafter be given by me in hearings before the Flaming and Zoning Commission er the City Cuundl for the City of Rexburg shall be truthful andcorrect 1 agree to comply with all City regulations and State laws relating to the subject matt, 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 2003 International Code in cases of any false seat tent or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if rot started win " 0 dal Permit id if w k stops for 180 days. �r�e�f �/a,- Srgnatur of Owner/Applicant DATE WARNING—BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE! Plan fees are non-refundable and are paid in full at the time of appfication beginning fiarm 12005 City of Resiburg's Acceptance of the plan review fee does not <ovstimte plan approval "Building Permit Fees are due at time of application** "Building Permits are void if your check does not clear" 2 Buildi,.g Safety Department ~ 9•Ex, a ap City of Rexburg y, CITY Or IDMURG 35 N E Phane: 208.372.2326 R Rexburg, D 83440 www.rexburg.org Fax:208.359.3022 Am<tlai Fatuity Cammwity Affidavit of Legal Interest State of Idaho Countyy Iof Madison I,.`la,.� Name cty S Address f4—� state Being fust duly sworn upon oath, depose and say: (If Applicant is also Owner of Record, skip to B) 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 propertywhich is the subject of the application. Dated thisday of / % y4 R^ p 20-1: Signatuce Subscribed and sworn to before me the day and year fust above written. Notary Public Residing at: My commission expires: Builaing Safety Department �7�.�TT� e CITY OF 35N 7d E City of Rexburg `i MMB V RG Phone: 208.372.2326 ry, Rexburg, ID 83440 WWW.rexburg.org Fax: 208.359.3022 Ameriwk ftni,C°mmuniry Property Lines 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. ll Signature Dale \l WJ ❑ owner or 0,Builder Printed Name 35N PIE burg, ID 83440 Buildi--f Safety Department - City of Rexburg Phone: 208.372.2326 www.rexburg.org Fax: 208.359.3022 Remodeling Your Building/Home (need total constructions and Mechanical valuations) $' Residential SURFACE SQUARE FOOTAGE First Floor Area Second floor/loft area Third floor/loft area Shed or Barn Commercial Construction Type: _ SURFACE SQUARE FOOTAGE: (Shall New Construction sq. ft. Commercial Remodel sq, ft. Commercial Addition sq. ft. Utility, Mise. Private Garage sq. ft. Storage sq. ft. Multi-Family/Single StudentH sing sq. ft per unit Manager Unit sq. ft. include the exterior finished Basement shed basement ar area I Deck (30" ov Jtp xaUAG VCIiY OP REXBURG au Amenm's Fmily Community excluding fire, electrical, plumbing, of the budding) the ex"Nor wall measurements of the building) 5 Building Safety DepartmentT°m` 35 N. h' E., Rrxbueg Id 83440 Clly of Rexburg V AG . — ?ahone — (208)359-3020 / F tune — (208)371-2344 / Fax — (?08)359-3022 trim 0 OWNER'SNAME lam,es�aJ � PROPERTY ADDRESS Permit# Water Meter Quantity: **************Water Meter Size: Required.!! y Plumbing Plumbing Contractor's Name (b 'l Y mittens Name Address State Zep Cell Phone ( ) Business Phone ( ) Pas ( ) Email (COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (Contracted Amount) $ (Inabrder the Lost of materneIr installed regardless ofthe padj mpp#or, it The fees luted under this inspertian one sbaQapp# to any andallplwmbing innallab'ow not spedfirally mentioned shooters on tbmform). ❑ Up to $10,000 (LOW colt of Mtm x 0.02) + 60 = $ ❑ Between $10,001- $100,000 ( (total cost of ay t m-1, 0 04 x 0.01) + $260 = $ ❑ Over $100,001 ( RESIDENTIAL (total c t f sAtern – ,0000 nn) x 0.005) + $1,160 = $ Neu' Single FaMBYDWdA-g, inctuding all buildings with wiring being mnstmcted on each pmperty. (+Based m /wing spam, see deSnidon below) ❑ Up to 1,500 sq ft - $130 Y, 1,501 to 2,500 sq ft - $195 ❑ 2,501 to 3,500 sq ft - $260 ❑ 3,501 to 4,500 sq ft - $325 ❑ Over 4,500 sq ft $325 plus $65 for each additional 1,000 sq ft. or portion thereof ($325 + ($65 x # of 1Addifi ! 00 soh _p ti t_hex f)). Neu^ Multi-FamilyDweBing (Contractors Only) ❑ Duplex Apartment $260 ❑ Three or more multi -family units: $130 per building plus $65 per unit: 41130 x # Qf b ,ldinga) + ($65 # f�tsl ❑ Existing Residence, and Detached Shop: $65 fee plus $10 per fixture up to the maximum of the corresponding sq. ft. of the Systems: 65 + (110 x # tt�e sll ❑ Gray Water Systema: $DO ❑ Lawn Sprinklers/Backflow Device: $65 ❑ Modular, Manufactured or Mobile Homes: $65 for sewer and water stub connections ❑ Multipurpose Fire Sprinkler and Domestic Water Supply System: $65 fee or $4 per spxinklee bead, whichever is greater Sewer&Water ❑ $38 Sewer Line ❑$38 Water line ❑$65 Sewer & Wates- if inspected at the same time ❑ $65 Sewer turnaround under house (change from septic to city) MISCELLANEOUS ❑ Plan Check: $65 per hour ❑ Technical Service: $65 per hour ❑ Gas Line: $65 ❑ Water Heater Replacement: $65 ❑ Requested Inspection: $65 ❑ Hydronic Heating: $65 + ($10 x # of manifolds/zones) *Living Space - space within a dwelling wilt intended for human habitation which may reasonably be utilized for sleeping, eating, cooking, dam& washing, recreation, and sanitation purposes. An unfinished basement[ is considered part of the living sp�aJce/��[l�[{�Q Stgnatuee of Licensed Covtracmr License number & E cp. date Dam \ ti Building Safety Department Ph ;E., Rexburg, Id 83440 City of Rexburg 8)359-3020 / Hodge, — (2081379 9344 Fax OWNER'S NAME %�r�l�Wtc3A� PROPERTY ADDRESS Pertnit# SUBDIVISION Required Y Address i)•0 Cell Phone Fax ( ) BLOCK Mechanical Phone ( ) CITT OF RMURG nmxmtF,n,ttycWamxmry (COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (Contracted Amount) $ (Include., the mst ofmakriab installed regardless of theparry supplying iR Thefeo listed xnderthir iup oson ripe shall apply m any and all mechanical ixstallah'oru not seeditea1# mentioned ehvs hee, ox thuf rm). ❑ Up to $10,000 (total t E yst x 0.02) + 60 = $ ❑ Between $10,001- $100,000 ((fatal cost of s;rstcm=,_10.000) x 0.01) + $260 = $ ❑ Over $100,001 ( (total c� f Us= -100000) x 0.005) + $1,160 = $ RESIDENTIAL New.Single Family DreaLbog including an buildings ssith wiring being constru on eachptoperry (mHasedon Bringapace see de&Wdon below) /fid ❑ Up to 1,500 sq ft - $130 Ef 1,501 to 2 0" sq ft - $195 ❑ 2,501 to 3,500 sq ft - $260 ❑ 31501 to 4,500 sq ft - $325 ❑ Over 4,500 sq ft $325 plus $65 for each additional 1,000 sq ft. or portion thereof New: MWti-Pami! ($325 + ($65 x # of ad iti al 1 000 q ft yDwclh'ng (Contractors Only) ❑ Duplex Apartment $260 ❑ Three or more multi -family units: $130 per building plus $65 per unit: (1130 x # ofhm ding) + ($65 # f ' 1 ❑ Existing Residence, Modular, Manufactured or Mobile Homes and Detached Shop: $65 fee plus $10 per **HVAC equipment being installed up to the maximum of the corresponding sq. ft. of the building 36 + ($10 # f Fixtures)) MISCELLANEOUS AivFOUS ❑ Plan Check $65 per hour ❑ Technical Service: $65 per hone ❑ Gas Line: $65 ❑ Water Heater Replacement: $65 ❑ Requested Inspection: $65 ❑ Fireplace/Solid Fuel Burning Appliance: $65 per inspection *1lving Space — space within a dwelling unit intended for human habitation which may reasonably be utilized for sleeping, eating, cooking, bathing, washing, oxcestion, and sanitation purposes. An unfinished basemen[ is considered pact of the living space. **Examples of HVAC Equipment -f ,mace replacement, solar, water heater, etc. 42 a-z„� lick - C- /-f Sigvatme u3sed Contractor License number & Exp. date Date B& lg Safety Departme► 35 N. P` E, Rexburg, Id 83440 City of Rexburg Phone - (208)359-3020 / Hotline - (208)372-2344 / Fax - (208)359-3022 OWNER'S NAME _ PROPERTY ADDRESS SUBDIVISION PHASE_ 1 cl i'OF REXBURG n nm.,;,.„: rmq cemmwly Pertn,t�t` I3 6wq 3 Pam &I Ient Power Required.!! ELECTRICAL Electrical Contractor's Name/ Y. W Business Name Address City State_ T-2yip._ ' x0 Cell Phone ( ) Business Phone ( ) Fax ( ) Email (COMMERCIAL/INDUSTRIAL) Total cost of electrical system (Cont onned Amon.) $ (ladxdu the mit ofmateiia4 insmlkd ngaedkrr oftb$Pae0 suPP/]zng (t. Tbefeet krtedaadertbir i skore . hal! rattPedfimkf mentlaned onaor on dufann) 0P% aPP,h'to any and allelaMtalinrtallafiew ❑ Up to $10,000 /4otal cost of cyst .o x 0.02) + 60 = $ ❑ Between $10,001- $100,000 ( (total cost of System 10 000) x 0.01) + $260 = $ ❑ Over $100,001((total cost nE y=t -100 0001 x 0.005) + $1,160 = $ Small Works (Contractors ONLY): $10 fee for work not exceeding $200 in war and not involving a change in service connections. Does NOT require inspection. RESIDENTIAL New.- Single PamilyDwehing includingaubuildings%gth"an,yoing constructed on eac6property. (+Basedon Bvingspace, see defuneten below) ❑ Up to 1,500 sq Et - $130 jC 1,501 to 2,500 sq ft - $195 ❑ 2,501 to 3,500 sq Et - $260 ❑ 3,501 to 4,500 sq ft - $325 ❑ Over 4,500 sq ft $325 plus $65 for each additional 1,000 sq ft. or portion thereof ($325 + ($65 x # f ddid 1 l 000 cq ft p t fl), New: Mule -Family Dwelling (Co.—_ only) ❑ Duplex Apartment $260 ❑ Three or more multi -family units: $130 per building plus $65 per unit.11130 # ' b 1d g4 + (865 # f mfigl ❑ Existing Residence, Modular, Manufactured of Mobile Homes, and Detached Shop: 310 branch circuit, up to the maximum of the corresponding sq. ft. of the building 865 + (110 x 2t branch plus cui pee ❑ Central Heating/Cooling Systems: $65 When NOT part of new residential or HVAC permit with no additional wit ng ❑ Spas, Hot Tubs, and Swimming Pools: $65 fee for each trip to inspect Pumps-IPat-,, frogaboa, Sewage (each motor) ❑ $65 up to 25HP ❑$95 - 26 to 200HP x$130 over 200 HP MISCELLANEOUS ❑ Temporary Construction Services ONLY: 200 amp or less, one location (for a period not to exceed 1 year) - $65 ❑ Temporary Amusement: $65 fee plus $10 per ride, concession or generator ❑ Irrigation Machine: $65 for center pivot plus $10 Per tower of drive motor ❑ Technical Service: $65 per hone ❑ Plan Check: $65 per hour ❑ Requested Inspection: $65 *Living Space - space within a dwelling war intended for human habitation which may reasonably be utilized for sleeping, eating, cooking, bathing, washin ee<+eatlon,��nd san�ation purposes. An "finished basement is considered part of the living space. r Signature of Iacemed Contractor License number at exp. date ate Building Safety Department o•=x•.� City of Rexburg � ;, CITY OF REXBURG 35844E Phone: 208.372.2326 Rexburg, ID 83440 www.rexburg.org Fac 208.359.3022 Am•nmk Family Co...;ry SUBCONTRACTOR LIST Excavation & Concrete:_ Le--iC—G-,,,re� Masonry:�6.�. y� 6&zll � Drywall: r'Ag Se L Floor M 4 Special Construction (Manufacturer or Sunnli EXEMPTIONS FROM STATE REGISTRATION 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 send a copy of your state registration or fill out this form showing your exemption and send it with your license renewal or your next permit application. (Thus list is a summarization of Idaho Code Tide 54 Chapter 5205, for full definitions of these exemptions please see the State's website at www ibol i rho go- /c_t__htw ❑ Currently State licensed pursuant to Tide 54 Idaho Code, Chapters: 3 Architects, 10 Electrical Contractors/Journeyman, 12 Engineers/Surveyors, 19 Public Works Contractors (exempt from fee only registration required), 26 Plumbing/Plumbers, 45 Public Works Construction Management Licensing Act (exempt from fee only registration required), or 50 Installation of heating, ventilation and air conditioning systems ❑ Employee or volunteer of a licensed contractor or part of an educational curriculum or nonprofit charitable activity with no wages or salary ❑ Employee of a US Government agency (State, City, County, or other municipality) ❑ Public Utility doing construction, maintenance, or development to its own business ❑ Involved with gas, oil or mineral operations ❑ Supplier doing no installation or fabricating ❑ Contracting a project or projects with a total cost less than $2000 ❑ Operation of a farm or ranch or consmacdon of agriculture buildings exempt from Idaho Building Code ❑ Any type of water district operations ❑ Work in meal districts for fixe prevention purposes Owner who performs work on own property or contracts with a registered contractor to do work as long as the property is not for resale within 12 months ❑ Owner or lessee of commercial property performing maintenance, repair, alteration ox construction on that Property ❑ Real estate licensee/property manager acting within Idaho Code ❑ Engagmg in the logging industry ❑ Renter working on the property where they live with the property owners approval ❑ Construction of a building used fox industrial chemical processing per Idaho Code ❑ Constructionof a modular building (defined by Idaho Code) to be moved out of state I h eb ertir that t,bove information is true and correct to the best of my knowledge. 10