HomeMy WebLinkAboutAPPLICATION - 14-00539 - 260 Baldwin Dr - SFRBuilding Safety Department x
Clty of Rexburg b CITY OF
IFE
35N I^E Phane: 208,372.2326 0 �URG
Rexburg, ID 83440 www.rexbUrg.org FOX. 203.3S9.3022 AmMats Fvmlly Commun�ry
Office Hours: Monday -Friday 8:00am-4:00pm
Single Family Residential Pre -Construction Checklist
Seismic Design Category – D
Ground Snow – 50 lbs. per sq. ft.
Frost Depth –36"
Roof Snow Load – 35 lbs. per sq, ft.
Wind Load – 90 MPH
The following items should be completed bC&ayaa submityour builda'ngpemnt apph'cakon.
Completion ofa BuildmgPcmnoApp6cadons You may print this application from out website
www.rexbLtz ory 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, from, 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 rescheck software is available online
at www=W d s
❑ Page 2 of 2 of the Applicator,' must include the Idaho Contra tot' R ai L Numb or the exemption form
must be completed and sign—ed see Page 10.
❑ Page 5 of the Application must be completed and signed by y ttr Plumb
❑ Page 6 of the Application must be completed and ssi ed by y cit Mechanicalun
❑ Page 8 of the Application must be completed and signed by yo EI_ e trid-.
❑ Home ownexs: please complete page 6 of the application if you will be doing your own electrical work,
❑ Truss details including engineered floor joists are required,
❑ Property Line Form needs to be signed by the builder or owner, see Page 4.
Subdivisions If you plan to build in a subdivision please check the Rexburg Development Code for any
tequirements such as, property setbacks, architecture bond approval, etc. This information is available from the
Planning & Zoning Department at the Annex Building located at 19 East Main.
NervResidendal Homes If your building permit is for a new home, you will need the parcel number (a potreJ
number is the county's proper[* identification which n ogatZer a plat of lana and a new physical address will be issued. If you
the
not know the parcel number and cannot find a record of it, please bdag the name of the subdivision, phase, and
the lot and block numbers. The entree, location is vital t ssur < nest add sin .
Remodels: If you are considering a remodel, a EM of the bid or estimate for the remodel must be submitted with
the Pemdt Application.
• 2 sets of Plans are required (may need IECC Review).
• Additions are the same requirements as new construction.
p4 waxaugo � .1
F b CITY OF
REXPlease COmplete the Entire Application,
0,,-
If the queeeon does not apply 611 f NA for-- applicable
dmatim'a Rvaity Communi y
RESIDENTIAL BUILDING PERMIT APPLICATION
35 N 1"E, REXBURG, ID 83440
208-372-2326
PARCEL NUMBER (We will provide this for you)
SUBDIVISION:_All b/Q CAA, fAl/0 UNITJ#
(Addressing is based on the mformation - must b� a a te) BLOCK#LOT# Z
Dwelling Units: Parcel Acres:
c- t.UN'IACT PHONE #.
PROPERTY ADDRESS:—�&,u V\
PHONE#:Home�+-Work (2 AJ Id 5 `"Z.�I.�O Cell
APPLICANT (If other than o er,u)
(Applicant if other than owner, a atatemevt aut6app Leant to act as agent for owner muat accompany this application)
o^""g
APPLICANT INFORMATION: ADDRESS
: CITY:
STATE
ZU' EMAIL aev
PHONE #: Home ( ) Work ( ) Cell
MAILINGADDRESS: CITY -
-STATE-ZIP-PHONE #: Home ( ) Work ( ) Cell
EMAIL FAX IDAHO REGISTRATION # & EXP. DATE
Howmany buildmga ue located nn rRi......,.v...>
Did You zecmtlypurrhase t6iapropcty7 V� Yn (IE yea, listptevious ownels same)
Ie this slot spliV7®YPS (please bdvg copy oEaewtegnl desaiPeon ofpmperty)
PROPOSED US
(ie. gte FamilyR dm Mdfi Family,Apaztmmu,Ravodd, Garage, Commcrial, Addiem, Etc)
APPIJCANTS SIGNATURE, CE.RnFlGnON AND AUTUORIZATION: Under penalryofpequry, I hereby certify that l have read Ns
Plavningand Zoning Commis,i.rxthe City Coandlfoxtthe Cityo R, burg ahDbeat ffifult dmaecc en betgivmm 1 mirb aRG before the
Starelaws rdatiagm the subjectmatterofd,6apph.do andheaeb authorized Py rym8rip P and
fotivspechona Purposea. NOTE: Thebuildin offidel ma y apxmmtaevee of the City mterupon the above-mmeoved property
rases of any false statement oz mlax neon offset in the apphcati or on ih pe plans on which the peams'�oz app otwa�I wesO �tamad�ontvoid ifnot
eezred within 180 days. Pe®itvoidififwarkstopsfox180days.
� �
Sign tu< 4- YV ') I---1—_/A—
DATE
WARNING— BUILDING PERMITMUST BE POSTED ON CONSTRUCTION ITE!
Plan fees are nun -refundable and are paid in f "the Nene of appGeauon bc,han.9jar-"1 ypp
review fee does not cnstitute pka appreva
*'BuRding Permit Feese re ducat time of applicadoaa*m*aBudding Pennies are void ifyour check does not chars,* _
Building Safety Department
City of Rexburg
CITY
_o F
3g, ^E URG
Rexburg, 11) 63440 www.MxbUrg.org Phone208.372.2326
FOX. 2083$9.3022 0 umrd_
_
Aamiry Conimunrry
Affidavit of Legal Interest
State of Idaho
County of Madison
I,
Name
Address
City
State
Being fust duly swom upon oath, depose and say:
(If Applicant is also Oumer of Record, skip to 13)
A. That I am the record ownet of the property described on the attached, and I grant my
percussion to:
to submit the accompanying application pertaining to that property,
B. I agree to indeumify, defend and hold Rexburg City and its employees harcdess from any
claim or liability resulting from any dispute as to the statements contained herein or as to the
ownership of the propetty which is the subject of the application.
Dated this
day of In
Sig --t
Subscribed and sworn to before me the day and year first above written.
Notary Public of Idaho
Residing at:
My commission expires:
3
Building Safety Department F>° "`
o CITY OF
Cly of Rexburg `.,
35 N 7^ E Phone: 206.3]2.2326
Rexburg, ID 83440 w Wrexbu or
�g Fax: 208.359.3021 4nre"'°'S lwmRy Communiry
Property Lines
Each site plan that is submitted to the City of Rexburg for the Building penult process requires that property lines
are shown accurately. It is the Developer's responsibility to correctly ideas 1on he 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 perfomted.
Accurate property line infoxtnation 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
guananteed fox accuracy. If you want to request a copy of your lot, see the front counter at the Courbaunity
Development Department.
I have read and understand the above requirements.
S gna ure
Date
�5�n Y�0 ars
t ❑Owner or ❑ Builder
Printed Name
Building Safety Department r°`�.„eun`° nr
4 7'1�,�.aTt-ra
35 N. 1"' E., Rexburg, Id 03440 C11y of Rexburg a EXBURG
Phonc —(2001359-3020 / IinrOne —(208)372 234E / F (200)359 3022 mnenraiw, ,n yc
OWNER'S NAME
PROPERTY ADDRESS Permit#
Water Meter Quantity: *****r***x****Water Meter Size:
-aequiremu Plumbing
Plumbing Contractors Name '? WA Business Nave '
m nu
Address -3"a'3 F c s=ice d+)
city Ammon State er.a.�,o ZiP�%i`14b
Cell Phone (L¢g) g�g5 — 17," Business Phone ( )
Psx ( )
(COMMERCIAL/INDUSTRIAL) Total coat of plumbing system (Contracted Amount) $
drder the ion oJarahn drinnnllyd rd4rr oJFbepanyrpplbg&Tbefeer/Irtedxader/bi'mrs ti.. type rbo!/
(Inrapply )o my and n/!p/wnbing rurtu//ationr
norrparifxally menGsaedebeaberr ss tbijr.).
❑ Up to $10,000(tota�rl st f est x 0.02) + 60 = $
❑ Between$10,001-$100,000 tl
❑ Oven$100,001=Yst 100001x0.01)+$260=$
RESIDENTIAL,
f4yt=-11000001x0.005)+$1,160=$
Ndefiaftbab o .) 1YC� rnebrd'ng dlbrdfdivge nirh rviHngbeing conenvefed on each propecty. (*Based on Going apace,
❑ Up to 1,500 sq ft -$130 ❑ 1,501m2,500sgft-$195
q. 2,501 to 3,500 sq ft - $260 ❑ 3,501 to 4,500 sq & - $325
❑ Over 4,500 sq ft $325 plus $65 for each additional 1,000 sq ft, or portion thereof 325 + 65 x
1000 q, h). ($ ($ # of additi �1
New.. Mulr1-Family Dsvelh'ag (Coavacrors Oa1y)
o Duplex Apartment $260
❑ Three of more multi-fam0y units: $130 per building plus $65 per unit (TI30 x # f 6, # f
o Existing Residence, and Detached Shop: $65 fee plus $10 per Fixture up to rhe rmxknum of the conespov nng
sq. ft of the building,( 5 + ($10 x #
❑ Gray Water Systems: $130
o Laura Sprinklers/Reckflow Device: $65
o Modular Mros-&-cored or Mobile Home.: $65 Fox sewer and ureter stub connections
❑ Multipurpose Fire Sprinkler and Domestic Water Supply System: $65 fee or $4 per sprinkler head, whichever
is greater
9srvsr& war"
o $38 Sava Line ❑$38 Water Line W65 Sewer & Water- if inspected at the same time
❑ $65 Saver, turnaround order house (change fmm septic to city)
dISCELLANEOUS
❑ Plan Check: $65 per hour
❑ Technical service: $65 per hour
❑ Gas Line:$65
❑ Water Heater Replacement: $65
❑ Requested Inspection: $65
❑ Hydronic Heating: $65 + ($10 x # of manifolds/zones)
Erving Space — space within a dwelling unit in¢nded for home, habiratio. which mry rensoeably be udlized Ear sleeping, eating, cooking,
nthingyra3iipg, a:aretion, and smitedon purposes. M unfairhed basement u considemd parr of the living space.
Building Safety Department
r, K, bu
,1d 8340 Coy of Rexburg Rf' i13 CRG
h n r'uh _ / 3010 / Hodi c _ (19M37' 134 Far - (2081359-3022
OWNER'S NAML
PROPERTY ADDRESS
OWNER'S CONTACT PHONL Permit#
OU NF_R'S EMAIL ADDRESS
Required./l./
I Mechanical
hleehanical ' .t.'ur'' Name 1 c� 1=Ajw
T� � Busivcss Name e� ff+ytd+T{ � �j ¢.
(COMMERCIAL/INDUSTRIAL) Total cost in
ofechardcal system (convected
(Ind drs dm mrrquwrrtiaG ircnu//rA ,rd/. >' dmouno)$
ium//;r,',vnrr pzd4rs/h,vnriorMr�Grrr a)rGis�.wi��/�/'f�mrL'raAunArr 2i<lrc r�arc
2a' hPr rLur! ppJ /o w,y anAuilrerL,.nira!
o Up to $101000 '
a Betweeo$10,001-$100,000 n,mlcrsrrs.�s 0.0.2)+60=$
((1on1 c, Fs' tf
D Over $100,001 x0.01)+5260=$
RESIDENTIAL, ((t, s_t� E } 10n x0,05)+51,160-
-5
New Single F—m'XDvrBing fnclnding all building, s,6 beu
see deffaiaoa below) wnng Scaasrmcred m escdpwperty. („Based on living spare
Cp m 1,500 sq ft- 9134
',501 m 3,500 sq ft- 5260 1,501 m 2,500 sq fr- $195
. 3,511 to 4500 sq& -$325a Ovcr 4,500sq It $325 plus $65 fur carp sddirooal 1,(X)0 sq hoor
portion rhemof
New: Mold-Pnmil(3325 + (S65. 2t f add"aI_ 1� h
7Owe/liag (Comvcmrs only)
o Duplcs Apaivment S260
H Three or more multi-farnil}-11s+
$130 per building plus $65 per unit M;3Q a #
v Existing Residence, Modular, Manufactured or Mobile Homes-
Detachedd Sh UuildiDIP) (S65 #— =Jam?
**HVm
AC egpmenn being ivemlled up cu rbc maximum of the comes lin P $65 fac P' -s $10 Per
4$67-- Pun R sq. R of the building
MISCELLANEOUS
I Plan Check: 365 per huc,
Technical Service: $65 per hour
Gas )erre: $65
C Water Heater Replace -em: $65
17 Requested lnspecdon:$65
o Fireplace/Solid Fuel Burning Appliance: $65 per inspeNon
,,,hi K 6Pau-space wi�hin a dwelling unie imm�ded fnr human habiranon wlilth mar reasonably 6e urilized for sleeping, eating, ..A.,h
,,,him az
, hing rccnnrinn, nil c:
,xL, 1p unPoilxhcd 6—ru :m- t
wr aF
I of HVdC£gmpmenr�furnace replanmrnt. solar, water hou" ems uiJerN Pur he 4vi�y, spec
J�,,matur fLeensW Cuntr-actor limon number h F1P.
- ..�._. " Dna
35 N. 1• S., Rexburg, Id 0344U Clty of Rexburg rj,l M -
I` Phone - (208)359-3020 /Hotline ^(2(1673]2-234a / Fnx - (208)359-3022 `\ J 1`EM U12L
OWNER'S NAME
PROPERTY ADDRESS
SORDIVISION Permit#
PHASE LOT BLOCK
Required/././ ELECTRICAL
Elecmcal Cmnbnoo'sName �11/(Glyj Business Name j'}f({A_ :i(_ LL
Address Z„S'Z, '
Ceu Ph"e f7.o9)� �, `i 5 Ph. ware- _zip�v`i�F Z
Bnaineaa Pnnne4t�Z-
Fax N-- i 1
COMMERC i_�Y VI
( IAS.JINDUSTRIAL) Tont cosit of electrical system (Convected Amount)
es,'.";,,k.msD* hPWpy
„xd„de/riWur&"s
❑ Up to$10,000 (tocol asr of=•= --x0.02 +60=
o Hetween$10,001-$100,0go ) $
' c Over $100,001 ((total a P y—Fe''—��=`0.01}+5260-q
Small Works (Contractors ONLY): 510t Fee korswork— no[ excee x 8200'n cost and not x 0.005) + Y1 d60 = S
service convections. Does NOT require inspection. involving a change in
RESIDENTIAL
.� New: •S/eB/e P°mi/Ypmeg� B, iocludlvg a!(buildrogs wird ovio beim
tt del4a(n®delow) B Bemevurrcdm ecce property (•Bamdonlisgg,p,tt
❑ Opm1,50psgft-$130 o 1,501 m2,50Us h-
9, 2,501m3,500sgft-$260 9 5195
❑ Over 4,5W sq 0 3325 plus $65 For each eddidonal 1,000 sq ft. or portion thee pf ($325 +
1 000 a., fi _�rvFl). t$65 x $+ f dei' I
New: AfaM-Pami0,DwN&W (Gmrraemrs
❑ Duplex Apamnucnt$260
c These or more multi -family units: 3130 per building plus S65 per umn (5130 # of h ' d'
❑ Existing Residence, Modular Manufactured of Mobile Homes, sod Detached Sfm 1 lA6 # f unu
blanch cirmiq up .,he maximum of the corresponding sq. fa of the building 1565 + Ctlp x $6yrFee plus siU per
❑ Central Heating/Cooling Systems: $65 When NOT pea of new residentiol or HVAC pe^ rm;t� !f
Wiring
o Spas, Hot Tuba, and Swimming Pouts: $65 fee for each trip to inspect
Paarp W.W,, L*xam, Sewage (eacd mote,)
o $65 up to 251 -IP ❑595 - 26 to 2W HP 0$130 over 200 HP 3
MISCELLANEOUS $'
❑ Temporary Construed" Sexvicea ONLY: 200 amp or less, one location (for a period not m exceed 1
o Temporary A .,,mamn$65 fee Plus $10 Petride, concession or generator year) - %5
o Irrigation Machine: $65 for center pivot plus $10 Pm tower of drive mom,
❑ Technical Service: %5 per hour
o Plan Check: $65 per holo
❑ Requested Inspection: $65
living Space- space ,utrd a dwelling ani, intended for human bebimdon nhi,Acony reesonnbly be Jul -d for sleeping, esting, making,
uvhing, w Shing n nd svdmdo pvrposa. An unfinish
/J ed dame onsidcre9drus, t of du, h'm' spore
Sigr,s(vrcoEt enxrdcunnanur lace ber&exp date �� D.m -l-
Building Safety Department oEa s
CRY of RexburgC I TY OF
J ao
35N Is E Phone: 208.372.2326
Rexburg, ID 834d0 www.rexburq.org Fax:20d359.3022 '�""^'°08�mlHaommutity
SUBCONTRACTOR LIST
Excavation &
Special Construction
(Manufacturer or Supplier)
Roof
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 neat permit application.
(this list is a summarization of Idaho Code Title 54 Chapter 5205, for full definitions of these
see the State's website at www ibo] Idaho gov cont html exemptions please
❑ Currently State licensed pursuant to Tide 54 Idaho Code, Chapters:
3 Architects,
MO Electrical Contractors/Joumeycran,
12 Engineers/Surveyors,
19 Public Works Contractors (exempt from fee only registration required),
26 Plumbing/Plumbers,
45 Public Works Construction Management Licensing Act (ex(mpt from fee only registration required), or
50 Installation of heating, ventilation and air conditioning systems
❑ Employee or volunteer of a licensed counselor 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 construction of agriculture buildings exempt from Idaho Building Code
❑ Any type of water district operations
❑ Work in rural districts fox fire prevention purposes
❑ Owner who performs work on own property or contracts with a registered contractor to do work as 1
the property is not for resale within 12 months ong as
❑ Owner or lessee of commercial property performing maintenance, repair, alteration or construction on drat
Property
❑ Real estate licensee/property, manager acting within Idaho Code
❑ Engaging in the logging industry
❑ Renter working on the property where they live with the property owners approval
❑ Construction of a building used for industrial chemical processing per Idaho Code
❑ Construction of a modular building (defined by Idaho Code) to be moved out of state
I hereby certify that the above information is true and correct to the best of my knowledge.
Signature
Print Name
Date
10