HomeMy WebLinkAboutAPPLICATION - 14-00328 - 170 W Main, Rigby - Purple Sage Wellness- RemodelBuilding Safety
Departmento•�
City of Rexburg
" e
`'
CITV OF
REXB
35 N 1=1 E
Phone: 208.372.2341
OY —
ammios Pomliy Cmnmwriry
Rexburg,www.rexburg.org ID 83440 www.rexbur or9
Fax: 208.359.3022
Office Hours: Monday -Friday 8:00=-4:00pm
Commercial/Multi Family Pre -Construction Checklist
Seismic Design Category — D
(unless soil evaluation confirms category C)
Ground Snow — 50 lbs. per sq. ft.
Roof Snow Load — 35 lbs. pet sq. ft.
Wind Load — 90 MPH
Prost Depth — 36"
The follaunng items shoald be completed he oreyou sahmityour building permit appl'cation. INCOMPLETE
APPLICATIONS WH—L NOT BE ACCEPTED.
Completion ofa Building PetmitAppitcation. You may print this application from out website
www.re�_s--_bn.o oxv of pick up a copy at the City Annex Building (address above).
Commercial Pemrits. (the following must be submitted with the Application)
❑ 4 sets of site plans and 3 sets of building plans stamped by a licensed professional
❑ Site plana and hwlding plans in PDF fomi.t must be bmitted after plans have been approved.
❑ Structural Calculations stamped by a licensed Engineer
❑ Energy Compliance Report: As per the 2006 IECC, a Compliance check must be completed and submitted
(the comcheck is available online at =.McwSodes.gov).
❑ Page 2 of the Application must include the Idaho Contractor's Registration Number or the exemption form
most be completed and s a see Page 10.
❑ Page 5 of the Application must be completed and signed by your Plumber.
❑ Page 6 of the Application must be completed by signed by your Mechanical Conti ctox.
❑ Page 7 of the Application must be completed and signed by your Electrician.
❑ Electrical panel layout and calculations most be included with the building plans. Plans will be
teviewed by the electrical inspector prior to issuance of the building permit.
❑ The Electrical application must include engineer stamped drawings for all commercial projects.
❑ Emergency Services Construction Peemit-fox fire related equipment only to be £died opt by the
contractor performing the work
❑ Exterior Lighting Plan including photometric layout. The lighting standards are included in this packet.
❑ Property Line form needs to be signed by the builder, see Page 4.
Electrical Pemti6 are now issued through the City of Rexburg. See Page 6 of the application.
Remodels If you are considering a remodel, a cow of the bid or estimate for the remodel must be submitted
with the Permit Application.
• 3 set of plans (may need IECC Review)
• Additions — Same as new construction
olybFenAC, -�
A; +p CITY OF
RURG Please Complete the Entire Application!
Ow -
If the question does not apply fJl in NA for non applicable
Amedmi fnmify Community
COMMERCIAL & MI LTI FAMILY BUILDING PERMIT APPLICATION
35 N 1 E, REXBURG, ID 83440
208-372-2326
PARCEL NUMBER: (We will provide this for you)
SUBDIVISION: ITNTTtt RT nPWr
KAddressing is based ongminn mn�Qn - must be accurate)
—CONTtCT I PHONE
PHONEPROPERTY ADDRESS: no U!A MQ'ir\
ap P . 1p1 / t. -
n
OWNER •' ••' �• r\
APPLICANT: (If other than owner)
(Applicant if othet than owner, a statement authotning applicant to act m agent for owner most accompany this application.)
APPLICANT INFORMATION: ADDRESS CITY:
STATE; ZIP EMAIL FAX
PHONE #: Home ( ) Work ( ) Cell ( )
CONTRACTOR c
MAILING ADDRESS:
PHONE: Cell#
Fax#
EMAIL IDAHO REGISTRATION # & EXP.
are located on
Did you recently purchase this property? No 6w yes, list previous owner's name) rl
Is this a lot split? jP YES (Please bring copy of new legal description of property)
PROPOSED USE:
(.e., Single Family Residence, Muln Family, Aletutaeot&4emode arage, Cottanetcial, Addition, Etc.) — CIRCLE ONE
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Undeepemltyofpequ„Iheobycenifydutl
have read thu application and natethat the Infomtaeoo herein is conte[ and Iswear doaMy information which may NICE., be given by me in hewin, before the
pb” ' and Zawig Cmmtvasim, or the City Coond fo, the City of Rexburg shall be toor ffil aM corner I ages to comply with all Gty. Moot and State hers relating
ne at badiog o ttter of this app4caaon t on appby muhomcd reer loft thea of the MY to..t op. the ab000noodened pao,ttt, fee inspections purposes. NOTE:
The bwlding official mB oke apettrut on epprovil issued under provisioosoftit,m3In[emauorul CodeN case of any false statemmtaredsrepresentation of feet
pphcetion or th Ivis on which the pemdtaapproval was based Permitvoidif not soared within 180 days. Permit votd,fooek stops for 180 days.
Signature of Ownu/Applicant DATE
Do you prefer to be contacted by fax, email or phone? Circle One
WARNING -BUILDING PBaMR MUST BE POSTED ON CONSTRUMON SITEI
Plan fete are non-refundable and am paid in fin et the tlme of apphtloon Lamson, jvmare t 20y
CloIneaRuilMot Pettoc Feetamdue sttimeofapp4atlanUaa aaBuiMmnraiew at dpenn:reata not ere rwWif appmvY
8 yourcheck does vot deerao
Building Safety Department aExBUp
°
City of Rexburg � s CITY OP
° IDREXBURG
35 g, E Phone: 208.372.2326
Rexburg, D 83"0www.rexburg.org FOx: 208.359.3022 /mariml Pomily CommvNry
State of Idaho
County
- of1Mag'(��\Jn
I, _3_1�5�0' \ 0
Name
City
Affidavit of Legal Interest
i1C) \�)o MC'"O
Addeess
15)m
Stare
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, slip 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 hatmless from any
claim or liability resulting from any dispute as to the statements contained herin or as to the
ownership of the property which is the subject of the application.
Dated this day of 2011_
Sgna u AQ
Subscribed and sworn to before me the day and year first above written.
V aode� ���ii
100 �����
%-.Y- Notary P c of Idaho
%pTAAy.':
Residing at
0 My coramai ion expires: /
'pro,. �F nc tOP o"
Building Safety Department
City of Rexburg
35N Ia E Phone: 208.372.2326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022
Property Lines
O`pgxe Vq4,
i A CITY OF
V Q
REXBURG
y
Amenrds Family Communiry
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 fording 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 Jaye, 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.
Signature
Printed Name
Date
Business Application
35 North 1°East
Rexburg, ID 83440
Phone. 204.359.3020
Fax:208.359.3022
egaxsvea
ti e CRY 04
° REXBURG
Amenroi lamily Cvmmuni p
Pleuse take the time to answer all questions so that we can further assist you and yourjaraity Thank You.
What type of business will be performed��
rn
Will the business have food preparations?
Yes_
nom/,
No (�
Will there be any cooking of foods?
Yes_
No_�-
Will there be any deep fat flying?
Yes_
N04
Will you have food disposal on site?
Yes_
No_)�
Will there be any maintenance or mechanical work in the building?
Yes_
No
Will there be sumps or floor drains in the facility?
Yes_
No
Will the business require more parking?
Yes_
No
Will the business have any chemicals on site?
Yes_
NO---Y--
Is this business occupying an existing building?
Yes
No
Will the business be doing any structural/or remodeling changes to the building? Yes_
No__�
Any changes to the electrical?
Yes
No
Any changes to the plumbing?
Yes
No
Is this business planned to be the same with different ownership?
Yes_
No
Will there be a change of occupancy?
Yes Y
No
tu�n+xe—\
Apphcant Phone "-
Date
l CodifY that The information That ghave provided above is to the best ojmy knowledge accurate arcQ hus
Building Safety Department e
35N NE Phone: 208.372.2326 City Of Rexburg Rk URG
Rexburg, ID 83440 x:208.359. Q2 www.rexburg.org
OWNER'S NAME
PROPERTYADDRESS CIO Permit#
SUBDIVISION
RequiredW Plumbing o
Plumbing Contractor's Name \\ af1C� F n (trd— �"rr/nliness NameV� (�1Q (� \
Address 16 x 9.2 � Q'.� da / City �Yt ✓° State - zip �3Hy3
Cell Phone €rbb7. 3L� :kjq,zL —Business
/x)Phone (VW) X13/3— y901/
Fax ( ) Email I'TCtfCI"iC�' N Y/rn7,S t `�6,y)t 'l C�r/1
- (COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (Cratxacted Amount) $ .2.99D0
(lndudes the rant of matetiah inrtallad orgardkn oftb, party nrpplying at Tbefeer fisted under tbu iarperkon type shall apply to any and allplumborg insWaua r
not sleafml# mentioned elremben on this form).
I. Up to $10,000 (total cost of yiL=— x 0.02) + 60 = $
❑ Between $10,001 • $100,000 ( (10-tal cost of svcteen — 10 000) x 0.01) + $260 = $
❑ Over $100,001 ((total cost of t - 100 nnn.�
RESIDENTIAL —��x 0.005) + $1,160 = $
New: Single Fa ofly Dwelling including all buildings with wiring being canstmcted on each m r
see definition below) P patty (Based on b'rang spare
❑ Up to 1,500 sq it - $130 ❑ 1,501 to 2,500 sq it - $195
❑ 2,501 to 3,500 sq ft - $260 ❑ 3,501 to 4,500 sq ft - $325
❑ Over 4,500 sq Et $325 plus $65 for each additional 1,000 sq ft. or portion thereof ($325 + ($65 x # f ddin n
1000 sq. Et ox or on 6 fl),
New: Muhl-FafrtilyDwelBng (Contractor. only)
❑ Duplex Apartment $260
❑ Three or more multi -family units: $130 per budding plus $65 per unit. ($130 x # f buildings) + (465 x # gftin1
❑ Existing Residence, and Detached Shop: $65 fee plus $10 per fixtute up to the maximum of the coxeespondts
sq, ft. of the building ($65 + (410 x_#_of f h ?��
❑ Gray Water Systems: $130
❑ Lawn Sprinklers/Backflow Device: $65
❑ Modular, Manufactured or Mobile Homes: $65 for sewer and water stab connections
o Multipurpose Fire Sprinkler and Domestic Water Supply System: $65 fee or $4 per sprinkler head, whichever
is greater
.Sewer & water
❑ $38 Sewer Line 0$38 Water Line ❑$65 Sewer & Water- if inspected at the same time
❑ $65 Sewer turnaround under house (change from septic he 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 - apace within a dwelling unit intended for human habitation which may reasonably be utilized fox sleeping, eating, cooking,
betivng, washing, re att d puq,oses. An unfinished ba einem is considered pact of the living space.
Signature of Licensed Contractor License another & Exp. date Date
BuildingSafety �`°"°"`�
y Department � a nn��..CITY
VVI T��rTOTFn�'+
City of Rexburg o: 0 1FD RG
35N NE Phone: 208.372.2341 01,—
Rexburg,
Rexburg, ID 83440 www.rexburg.org Fax: 206.359.3022 Amedmk ss.R, Cammxniry
OWNER'S NAME
PROPERTY ADDRESS Pemut#
SUBDIVISION
PHASE m
Requiredffl
Mechanical
Mechanical Contractor's Name Business Name
Cell Phone ( ) Business Phone ( )
Fax ( ) Retail
(COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (Contracted Amount) $i
i.
(Im.'ludes the zvt ofmatesia4 i,utalledregmdlerr of tbeparty rupphdng it Tbefeer k'}ted under Ibu ixrper6on type rha!lappdy to nay and allmeebanira!
tmtallahow notr/maftr lly mentioned elremhm m thufarm).
❑ Up to $10,000 (L0101 c9st of U–Stern x 0.02) + 60 = $
❑ Between $10,001- $1002000 ( (to a7 ca t of Mt –10m�) x 0.01) + $260 = $
❑ Over $100,001
RESIDENTIAL ( (total m t f�m— 100 ON x 0.005) + $1,160 = $
seer deSnhion D INwg, mcludmg agbuddmgs mth wrrtngberng constructed on each property. (aBased on h'vinng space,
❑ Up to 1,500 sq ft - $130 ❑ 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
New Mali-Famil ($325 + ($65 x It f dditinal 1 000 q ft o p A th fl).
yl7sunring (Contractors Only)
❑ Duplex Apartment $260
❑ Three or more multi -family units: $130 per budding plus $65 per unit: 0;13Q X # of bail ggl + (f6s � t s
❑ 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. fic of the building
+($10x# ffxn ,ll
MISCELLANEOUS 65
❑ Plan Checic $65 per hour
❑ Technical Service: $65 per hour
❑ Gas Line: $65
❑ Water Heater Replacement: $65
❑ Requested Inspection: $65
❑ Fireplace/Solid Fuel Burning Appliance: $65 per inspection
"Citing Space – space within a dwelling unit intended for human habitation which may reasonably be utilized for sleeping, eating, cooling,
)athing, washing, recreation, and sanitation purposes. An unfinished basement is considered part of the living space.
'*Examples of HVAC Equipment -furnace replacement, solar, water heater, etc.
Signature of Licensed C.I ctot
License number & Exp. date Date
35 N. I" E,Rexburg,Id 83440 Buli..ing Safety Departmen.
Phone - (208)359-3020 / Hodine - (208)372-2344 / Fax - (208)359-3022 CRy Of RB%burg
OWNER'S NAME _
PROPERTY ADDRESS
SUBDIVISION
CITY OF
co. teo
REXBURG
Amenmi PomBy ummwlry
RequiredlY ELECTRICAL
Qtke41 St#vFcL
Electrical Contractor's Name Sgt it 1 G le dh.l.. Business Name S E= V 1 L -e' I x�-F_ ;Fl��
Address 90 -Fr E. 3l AI City 121 (,taC 5tate� Zip fi35cy�
Cel Phone ?,C% ,� 9 -(� L 7 Business Phones Phone ( ))
Fax ) Email_ S' Seevi,,, CJecyr tG ✓ %li/art Ca+,..
(COMMERCIAL/INDUSTRIAL) Total cost of electrical system (Contracted Amount) $ F�
(Ixcl.der the tort ofmateaa6 ixttalkd reganllw.r of the pmry sxpplyixg id Thefeer hAId.xsIr tbu ixspaasa type rh,11 apply is, axd all elesMralinRallakoso
flat cpeafualty mexkoxed eknvhor ox thu font).
- Up to $10,000 (t rail r= of system x 0.02) + 60 = $ .L^t .50 't too
❑ Between $10,001- $100,000 ( (total cost of cyst=_10 (mo) x 0.01) + $260 = $
❑ Over $100,001 ( (total cost of sst -100 000) x 0.005) + $1,160 = $
Small Works (Contractors ONLY): $10 fee for work not exceeding $200 in cost and not involving a change in
service connections. Does NOT require inspection.
RESIDENTIAL
Now, Snrgle Family Dwelling, ineluding all buildings with
see definition below) wiring being conetrucred on each property. (aBased on living space,
❑ Up to 1,500 sq ft - $130 ❑ 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 del I
1 00Q sq. ft or portion _�e Fl),
New: Multi-F—,Yj Dwelfinp (Conti __ Only)
❑ Duplex Apartment $260
❑ Three or more multi -family units: $130 per building plus $65 per unit 44130 x # of bergs)+ (9'6S+tem)
❑ Existing Residence, Modular, Manufactured of Mobile Homes, and Detached Shop: $65 fee plus $30 per
branch circuit, up to the maximum of the corresponding sq. ft. of the building 365 + ($10 x # branch .a a
❑ Central Heating/Cooling Systems: $65 When NOT part of new residential or HVAC permit with no additional
Wiring
❑ Spas, Hot Tubs, and Swimming Pools: $65 fee for each trip to inspect
Ramps-Ipatec, Irrigation, Sewage (each motor)
❑ $65 up to 2514P ❑$95 - 26 to 200HP ❑$130 over 200 HP
MISCELLANEOUS
❑ Temporary Construction Services ONLY: 200 amp or less, one location (for a period not to exceed 1 yeat) - $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 hour
❑ Plan Check $65 per hour
❑ Requested Inspection: $65
*Living Space - space within a dwelling unit intended for human habitation which may reasonably be utilized for sleeping, eating, cooking,
bathing, was cceatioq and saturation purposes. An "finished basement is considered part of the living space.
Builaing Safety Department
35 N. 111 E., Re brag, Id 83440 City of Rexburg
Phone - (208)359-3020 / Hotline - (208)372-2344 / Fax - (208)359-3022
LOCATION OF WORK TO BE DONE
Street Address Where Work Will Be Done:
Business Name Where Work Will Be Done:
Dates for Work to Be Done:
Contact Person:
Phone Number: ( 1
To
Cell #
RequiredIV FIRE SPRINA ER
Fite Sprinkler Contractor's Name:
Business Name
CITY OF
REXBURG
AmMmi FumllyGmmmuniry
Address City State lip
Cell Phone ( ) Business Phone ( )
Fax ( 1
(COMMERCIAL/INDUSTRIAL) Total cost of fire sprinkler system (Contracted Amount)
(Includes the cost of materials installed regardless of the par_* suppyng it. The feet luted under this inspection Zype
shall apply to any and all fire alarm installations not specifically mentioned elsewhere on this form).
❑ Up to $10,000 (total cost of system x 0.02) + 60 = $
❑ Between $10,001- $100,000 ( (—to—W cost of system —10 OOW x 0.01) + $260 = $
❑ Over $100,001 ( (total cost of system — 100 000) x 0.005) + $1,160 = $
MISCELLANEOUS
❑ Existing Inspection Base: $60
❑ Re- Inspection: $65 per sip
❑ New construction $1 per sprinkler head ($2,000 maximum) number head
Signature of Licensed Contractor License number & exp. date Date
Building Safety Department "°
Cll'Y OF
City of Rexbur a DnvnG
35 N. 1�1 E., Rexburg, Id 83440 9 1��CGt��UUll1\
Phone - (208)359-3020 / Hotline ^ (208)372-2344 / Fu - (208)359-3022 nr
n.n;m; a,.urm._i,
LOCATION OF WORK TO BE DONE
Street Address Where Work Will Be Done:
Business Name Where Work Will Be Done:
Dates for Work to Be Done:
Contact Person:
Phone Number: ( 1
RequrredN
Fixe Alarm Contractor's Name
Business Name
To
Cell #
FIRE ALARM
Address City-state-zip-
Cell
ityStateZipCell Phone ( ) Business Phone ( )
Fax (_ 1
(COMMERCIAL/INDUSTRIAL) Total cost of fire alarm system (Contracted Amount)
(Includes the cost of materials installed regardless of the party supplying it The fees fisted under this inspection type
shall apply to any and allfire alarm installations not speOcaly ment oned elsewhere on thi form).
❑ Up to $10,000 (total cost of system x 0.02) + 60 = $
❑ Between $10,001-$100,000 ( (total cost of system —10 000)x 0.01) + $260 = $
❑ Over $100,001 ( (total cost of system —100 000) x 0.005) + $1,160 = $
MISCELLANEOUS
❑ Plan Review per Hour: $65 per hour
❑ Re- Inspection: $65 per trip
Signature of Licensed Contractor License number & exp. date Date
10
SUBCONTRACTOR LIST
Excavation &
Masonry:
Floor
Special Construction
(Manufacturer or Supplier)
Floor/Ceiling
Siding/Exterior
EXEMPTIONS FROM STATE REGISTRATION
As of January 1, 2006, the City of Rexburg can no longer sell permits without having a copy of Yom State
registration number or your exemption from the State registration. Please send a copy of your state registration of
fill out this form showing Yom exemption and send it with your license renewal or your next permit application.
(This list is a sutnaharization of Idaho Code Title 54 Chapter 5205, for full definitions of these exemptions please
see the State's website at wwww.ibol idalao go /cont him)
❑ Currently State licensed pursuant to Title 54 Idaho Code, Chapters:
3 Architects,
10 Electrical Conrractofs/Journeyman,
3 Engineers/Surveyots,
19 Public Works Contractors (exempt from fee only registration requited),
26 Plumbing/Plumber,
43 Public Works Construction Management Licensing Act (exempt from fee only registration required), or
5Q 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 it own business
❑ Involved with gas, oil or mineral operations
❑ Supplier doing no installation or fabricating
❑ Contracting a project of projects with a total cost less than $2000
❑ Operation of a farm or ranch of construction of agriculture buildings exempt from Idaho Building Code
❑ Any type of water district operations
❑ Work in final district for fire prevention purposes
tr- Owner who performs work on own property of contracts with a registered contractor to do work as long as
the property is not for resale within 12 months
�} Owner of lessee of commercial property performing maintenance, repair, alteration of construction on that
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 ptoperty 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
the above information is true and correct to the best of my knowledge.
ZSignature (� Date
�\� \ � R. &SSL(N
Print Name
12
Building Safety Department
Cily of Rexburg
35N NE Phone: 208.372.2326
Rexburg, ID 83440 w W.rexburg.org Fax:208.359.3022
oQµxaup�
t p r7CITY
V�I T��YTOmF
R IU3 RG
n
Amen�ai fnmtty fommuniq
Site Plan Checklist Permit Number.
Applica' Infor a ton
Applicant Q Q (VS1 Phone: FAX:
WQ
Applicant's Address: l'�Q Mn' City: STi Zip:
Project Address: ��
Recorded Owner�phone: _ FAX:Recorded Owner Address: 'tom,,'',, Q�,y,,,
City: ST: XjS �Zip: hcC�Q
Development Information
❑ L Site plan must be drawn to scale, be legible and also be submitted electronically if possible.~
❑ 2. Adjoining streets labeled.
❑ 3. Right-of-way location and width, curb to curb widths and sidewalk location.
❑ 4. Building location, sq footage and dimensions, with distance to property lines and distances
between buildings.
❑ S. Show existing and proposed easements.
❑ 6. Existing utilities (waterlines, sanitary sewer lines, manholes, storm drains).
❑ 7. Proposed utilities including tie in location to existing services and new easements.
❑ 8. Proposed storm drain and sanitary sewer elevations (for pipe inverts at manholes and catch basins).
❑ 9. Storm drainage plan for parking lot and roof areas, with calculations.
❑ 10. Fire hydrants and fire suppression lines (including tie to City lines).
❑ Sprinkled ❑ Not Sprinkled
❑ 11. Indicate Fire apparatus access.
❑ 12. Parking (including parking lot, drainage arrows, dimension of lot, distance between rows, and total
numbers).,
❑ 13. Landscaping (type and total area, including dimensions).
❑ 14. Trash facilities.
❑ 15. North Arrow
❑ 16. Drawing to Scale, including a graphic scale (11 V2 x 17" paper if possible).
❑ 17. Proposed street improvements (curb, gutter, sidewalk, pavement, etc.)
❑ 18. Legal description of proposed building site included.
❑ 19. Percent of lot covered by building or paving calculated.
1120. Show 10% snow storage area.
❑ 21. Distance of entrances from street comer indicated.
❑ 22. Current Vicinity Map. (81/2 x I 1") at 15'= 300' scale, showing location of the property.
❑ 23. Lighting Plan
NOTE: SITE PLANS MUST BE COMPLETE AND SUBMITTED FOR REVIEW BEFORE THE PROJECT WILL BE
PLACED ON THE PLANNING & ZONING AGENDA. -q�
Building Safety Department°.
o
L
City of Rexburg Ji z CITY OF
REXBURG
35N I'� E Phone: 208.372.2326Ow —
Rexburg, ID 83440 www.rexburg.org Fax:208.359.3022 Arntl'b Anmlly Communiq
Business Application Questionaire
(fox the purpose of wastewatu tx,,, tier)
1. Type of business or establishment?
2. Will this business bedoing any type of food preparation or cooking?
3. What type of food preparation or cooking will be done?
4. Will there be any deep fat fi*g? Yes No
5. Will the facility have food disposal systems? M
6. Are you a business planning to occupy an existing building? y IL5
or, are you designing a new facility? EM
7. Will your business have chemical storage? Yes No
8. Will this facility operate year round? Yes )�' No
9. Will there be any grease traps or sumps at the facility? Yes No
10. Will there be any types of chemicals used at this facility, other than household
cleaning solutions? Yes No
11. Is there any manufacturing of products at this facility? Yes No
Applicant Signature Date
Commercial Building Application
Fwae TM.PrM
BuildingAddMS; nb
City of Rigby
158 W Fremont Ave
Rigby, ID 83442
(208) 745-8111
Leoal Oescr1won: LM Blnrk
SuMiivisirxi
Size of Parcel: Square Feet Awes
Zoning 6Nstrfet: Fidsting Use: W J 4 oa�. Proposetl Use: 1-(- - (}t�IC �('
0 (g7p`�9y� lo' -Y\
❑ New ❑ Addition Remodel 0 Repair ❑ Foundation Only
0 Retail i# of units i 0 Office Space (# of units 1 0 Storage 0 other
tad esemebl s«l a cege,wa canshucAon te,mwire ioti 6�
Sq. A. First Flow Sq. ft, Other Floom —Sq. ft. bacament Total Sq. ft
BOR -street Parking spaces #Seat6(cepacdif Type of heaingtAC
Subcontractors: PlumbingElecbirian94¢,,.i jgyVyy,
and u dl.M is uue arra correct to the best of their
lean ll rro(be isresu�et uMnh�l plan arelllonlinancee and lees regulating building Construglwl and acknowledgs only for the wor es that building
specifically described: no changes to submitted planpinowed e Of addifional work or struuM areal the City, and that the approied Permit Ikwretl unless submitted separately for
review and approval.
Cmlaaof681pghney�]\
Uah
Ow✓.6lemryr.�,� � i
City, BIB, ZIP:'1�Y.
ZIP
q_C;eIYBuAs::
► c .
Leoal Oescr1won: LM Blnrk
SuMiivisirxi
Size of Parcel: Square Feet Awes
Zoning 6Nstrfet: Fidsting Use: W J 4 oa�. Proposetl Use: 1-(- - (}t�IC �('
0 (g7p`�9y� lo' -Y\
❑ New ❑ Addition Remodel 0 Repair ❑ Foundation Only
0 Retail i# of units i 0 Office Space (# of units 1 0 Storage 0 other
tad esemebl s«l a cege,wa canshucAon te,mwire ioti 6�
Sq. A. First Flow Sq. ft, Other Floom —Sq. ft. bacament Total Sq. ft
BOR -street Parking spaces #Seat6(cepacdif Type of heaingtAC
Subcontractors: PlumbingElecbirian94¢,,.i jgyVyy,
and u dl.M is uue arra correct to the best of their
lean ll rro(be isresu�et uMnh�l plan arelllonlinancee and lees regulating building Construglwl and acknowledgs only for the wor es that building
specifically described: no changes to submitted planpinowed e Of addifional work or struuM areal the City, and that the approied Permit Ikwretl unless submitted separately for
review and approval.
Cmlaaof681pghney�]\
Uah
Ow✓.6lemryr.�,� � i
P.O Box 280
35 North ist East
Rexburg, ID 83440
Phone(208)359-3020
Fox (208)359,3022
Emaitiodel@rexburg.org
City of Rexburg
State of Idaho
Grease Traps and Inspections
TO ALL: Local Business Owners and Management
..,
CITY OF
RExBURG
_ .ow—
Aialm4hsal,Gmmwly
The City of Rexburg requires that all facilities dealing with any fats, oils, or greases must
have grease traps in place in order to stop them from discharging into the city collection system.
Fats, oils, and greases cause blockage in private services as well as the public sewer lines and also
create a large cost to treat and remove them at the city Wastewater Treatment Plant.
The City of Rexburg is currently upgrading its record keeping system in regards to the
cleaning of grease traps and stepping up its monitoring to assure compliance. Due to the lack of
reporting from some existing businesses and documents not being given to new coming businesses,
we are sending this letter out to help businesses and ourselves be on the same page. Please fill out
the attached forms. Ane u_ r_..__ , .
Inforinatio Fan) and inay 'sr Bard the followingrn e
Each business is responsible for the cleaning and reporting of their grease traps to the City
of Rexburg. Enclosed is a Grease Trap Cleaning Form. Please make copies of this. The Grease Trap
Cleaning Foran is a written record that must be filled out after every grease trap cleaning whether
traps are cleaned twice a week, once a week, once a month, etc. At the end of each month the
compiled Grease Trap Cleaning Forms need to be mailed to the City of Rexburg. The address for
mailing is on the forms. Make sure to make copies for personal records.
Also included is a Grease Trap Cleaning Log. Please make copies of this. The Grease Trap
Cleaning Log needs to be kept and turned in every six months to the City of Rexburg and a copy
kept by the business. This log will keep just the dates cleaned and the name of the company that
cleans the traps.
The City of Rexburg will do random inspections of facilities to assure that proper cleaning of
grease traps have been done and that there is not (%=Mdy any problems with fats, oils, or greases
being discharged into the system. If the City has any concerns that proper cleaning and removal of
grease in the traps has not been met, or if a business fails to comply by not sending in the cleaning
forms and logs, we will have to take action to assure that requirements are met.
We hope that we can assist you if you have any questions, so feel free to call us at (208)359-
3035. Ask for Donna, Jade, or Ron.
P.S. Several businesses that have been outstanding in sending us the proper information in the past
will get this letter also. We want to thank you for your efforts to help us create a quality
Pretreatment Program.
Thank You,
Wastewater Treatment Plant
FOAM A
BUSINESS INFORMATION FORM
Name of Business:
r O
Address ofBusiness:
Mailing Address:
Contact: Phone Number: _ aa 0' 41, Qty}
2nd Contact: Phone Number:
Does your business work with any Fats, Oils, or Greases? Yes _ No
Do you have grease traps rmtendy at your facility? yes _ No
How regularly do you have your grease traps cleaned?
Please Return to the City of Rebn
City Hall
C/O Waste Water Department
P. O Box 280
Aexbueg, ID 83440
Form A
(Continued)
BUSINESS INFORMATION FORM
(Fill Out If Applicable)
I. On the liner below, please describe the location ofyourgFeme !rapt and whether or not tby are imide or outride
yourf-hty.
Location of Grease Traps:
2. On the fines below, please describe the one and sive ofgrease trapsyou use atyourfadhty to the best ofyour
knowledge.
Type and Size:
The City of Rexburg
Grease Trap / Receptacle
To the CITY OF REXBURG: Cleaning Form
On this date:
Grease trap Location
(Month) (Day) (,,�)
(Restaurant Name and Address)
Cleaned by:
(Person on Persons Involved from Restaurant)
Spent oils and/or grease hauled away by:
(Company who does the Clsau
Or stored until: then hauled away me
(Month/Day/Year) (Month/Day/Year)
I certify under penalty of law that I have personally examined and am familiar with the information
submitted herein, and based on my inquiry of those individuals immediately responsible for
obtaining the information, I believe the submitted information is true, accurate, and complete. I am
aware that there are significant penalties for submitting false information, including the possibility of
fine and imprisonment See 18 U.S.C. 1001 and 33 U.S.C. 1319. (Penalties under these statues may
include fines up to $10,000 and/or maximum imprisonment of between 6 months and 6 years)
(Manager or Owner, Fust and Iasi Name) (Date)
(Address and Phone Number)
Please Mail To;
City Hall
C/O Waste Water Department
P.O Box 280
Rexburg, ID 83440
Grease Trap /Receptacle Cleaning Log
Six Month List
(Name of Restaurant)
This form is to be filled not each time that the grease trap is cleaned by the person who
cleaned the ttaps/receptacles. Then, every six months it is to be send into the following address.
City Hall
C/O Waste Water Department
P.O. Box 280
Rexburg, ID 83440
Date Trap/Receptacle Cleaned Person overseeing it from restaurant
NOTE: Of filled before end of six months; just stat on new copy like this and send both at due date)
Grease Trap/Interceptor Information
For the
City ofRexburg
Introduction
Oil, grease, and solid wastes that are discharged into the sanitary sewer by commercial or
industrial users can cause a number of problems in the sewer system. Grease and o$ have poor
solubility and tend to separate from the aqueous phase. Although this characteristic is advantageous
in facilitation, the separation of oils and grease in pretreatment devices such as grease traps and
interceptors, it complicates the transportation of wastes in the sewer and can complicate treatment
and disposal at the wastewater treatment plant.
Oil and grease in wastewater from food service facilities can result in decreased carrying
capacity of sewers due to congealed, cooled grease which coats the inside of the pipes. Once a pipe
becomes constricted, the potential for a stoppage increases. Stoppages can and will eventually cause
sanitary sewer overflows. In order to ensure efficient sewage treatment, protect the sewer system,
and protect public health, the City of Rexburg has established the following requirements for
businesses in reference to the City's sewer use ordinance #800 and the code of federal regulations,
46cfr-part 136 pretreatment rules and guidelines.
General Requirements
A. Any type of business where oil and grease may be discharged into a public sewer shall
have aninterceptor/trap.
B. Each interceptor or trap shall be installed and connected so that, at all times, it is easily
accessible for inspection, cleaning, and removal of grease and other material. Interceptors or traps
must be installed outside of the building and shall be constricted in a manner so as to exclude the
entrance of surface water or groundwater.
C. The interceptor or trap shall be situated on the user's premises.
D. Buildings remodeled for use requiring interceptors/traps shall be subject to these
regulations.
E. Waste discharges from fixtures, including but not limited to, scullery sinks, pot and pan
sinks, mop sinks, soup kettles and floor drains, shall be drained into the sanitary sewer through an
interceptor/trap. Toilets, urinals, dishwashers, and other similar fixtures shall not drain through the
interceptor/trap.
F. Interceptors and traps shall be maintained in efficient operating conditions. They are to be
cleaned regularly as deemed necessary by the business or Industrial Waste Inspector. The use of
chemicals, bacteria, or other agents to dissolve grease or otherwise clean grease interceptors/traps is
specifically prohibited. No such grease shall be introduced into any drainage piping or public or
private sewer.
G. The size of a grease interceptor/trap most be installed at a capacity of 1,500 gallons.
H. A record of grease trap cleating or copies of grease interceptor servicing most be
maintained and be available for inspection by the City's representative.
PP over Grease Tran Design
1. Inlet Pipe: Where oils and greases enter into the grease trap.
2. V Chamber: Oils and greases will float to the top and be trapped from
going out the discharge pipe.
3. 2nd Chamber: Where wastewater drains oat of the chamber.
4. Access Ports: Two separate fids that allow for cleaning or viewing of the chambers.
5. Baffle: A divider between the chambers used to keep the oils and
greases from moving into the discharge.
6. Discharge Pipe: A 90 degree angled pipe used where water drains into system.
A designed grease trap or sump will hold at least 1,500 gallons and contains two chambers.
The water enters the trap through a drain or a pipe and goes into the first chamber. The oils and/or
grease will float and be captured in the top half of the chamber. Any grit will sink to the bottom.
The baffle prevents greases or oils from escaping into the discharge pipe. The discharge of the trap
needs to have a 90 degree bend to prevent carry over.
Design Standards for structures less than 25,000 square feet,
Note: Please see Rexbures Development Code for design standards for strarmers over 25,000 square feet, or for
developments located in the Neighborhood Business District or Central Business District zones.
Please demonstrate how your project meets the folim.g r gtticements
Developments with facade over 40 feet in linear length shall incorporate wall projections or recesses a minimum
of 3 foot depth and a mutit own of 8 contiguous feet within each 40 feet of facade length and shall extend over 20
percent of the facade. All sides of a structure dearly visible from a public street shall be so treated.
Developments shall use animating features such as arcades, display windows, entry areas, or awnings along at least
60 percent of the facade. v—
Where principal buildings contain additional, separately owned stores, which occupy less than twenty-five
thousand (25,000) square feet of gross Boor area, with separate, exterior customer entrances:
a. The street level facade of such stores shall be transparent between the height of three feet and eight feet above
the walkway grade for no less than 60 percent of the horizontal length of the building facade of such additional
stores.
b. Windows shall be recessed and should include visually prominent sills, shutters, or other such forms of fuming.
Building facades shall include a repeating pattern that shall include no less than three of the dements listed below.
At least one of theses elements shall repeat horizontally. All elements shall repeat at intervals of no more that
thirty (30) feet, either horizontally or vertically.
-Color change
-Texture change
-Material module change
-Expression of architectural or structural bay through a change in plane no less than 12 inches in width,
such as an offset, reveal, or projecting rib.
Roof lines shall be varied with a change in height every 100lineat feet in the building length. Parapets, mansard
roofs, gable roofs, hip roofs, or dormers shall be used to conceal Bat roofs and roof top equipment from public
view. Alternating lengths and designs may be acceptable and can be addressed during the preliminary
development plan.
Predominant exterior building materials shall be high quality materials. These include, without ]mutation:
-Brick
-Wood
-Sandstone
-Other native stone
-Tinted, textured, concrete masonry on,
Facade colors shall be low reflectance, subtle, neutral, or earth tone colors. The use of high intensity colors,
metallic colors, black or fluorescent colors is prohibited.
Building trim and accent areas may feature brighter colors, including primary colors. Neon tubing shall not be an
acceptable feature for trim or accent.
Predominant exterior building materials as well as accents shall not include the following:
-Smooth-faced concrete block
-Tilt -up concrete panels without mitigating surface treatment
-Pre-fabricated steel panels
Each principal building on a site shall have dearly defined, highly visible customer entrances featuring no less
than three of the following:
-canopies or porticos
-overhangs
-recesses/projections
-arcades
-raised corniced parapets over the door
-peaked roof forms
-arches
-outdoor patios
-display windows
-architectural details such as the work and moldings which are integrated into the building stmcture and
design
-integral planters or wing walls that incorporate landscape areas and/or places for sitting
No more that 60 percent of the off-street parking area for the entire property shall be located between the front
facade within the front yard of the principal building(s) and the primary abutting street unless the principal
building(s) and/or parking lots are screened from view by out -lot development (such as restaurants) and
additional tree plantings and/or berms.
Parking shall be located to the rear of the building or screened so that it does not dominate the sovetscape.
Fences, hedges, berms and landscaping shall be used to screen parking areas. When large parking lots are
necessary, increase the landscaping to screen the lot and divide the lot into smaller components. Landscape
islands must be provided in the interior of large lots. These may double as snow storage areas in the winter
months.
The minimum setback for any building facade shall be in accordance with the requirements for all Commercial
zones, except Community Business Center. Where the facade faces adjacent residential uses an earthen berm
shall be installed, no less than 6 feet in height, containing at a minimum, a double row of evergreen or deciduous
trees planted at intervals of 15 feet on center. Additional landscaping may be required by the Planning
Commission to effectively buffer adjacent land use as deemed appropriate. Any and all additional landscape
requirements of all the Commercial zones, except Central Business District, shall apply.
Areas for outdoor storage, truck parking, trash collection or compaction, loading, or other such uses shall not be
visible from public or private rights-of-way.
No areas for outdoor storage, trash collection or compaction, loading, or other such uses shall be located within
20 feet of any public thoroughfare of street, public sidewalk, or internal pedestrian way.
Loading docks, truck puking, outdoor storage, utility meters, HVAC equipment, trash dumpsters, trash
compaction, and other service functions shall be incorporated into the overall design of the building and the
landscaping so that the visual and acoustic impacts of these functions are fully contained and out of view from
adjacent properties and public streets, and no attention is attracted to the functions by the use of screening
materials that are different from or inferior to the principal materials of the building and landscape.
Non -enclosed areas for the storage and sale of seasonal inventory shall be permanently defined and screened with
walls and/or fences. Materials, colors, and designs of screening walls and/or fences and the cover shall conform
to those used as predominant materials and colors of the building, If such areas are to be covered, then the
covering shall conform to those used as predominant materials and colors on the buildings.
Temporary sales/displays, such as Christmas trees, landscape materials, and fireworks, shall follow all outdoor
requirements for all the Commercial zones, except Community Business Center, as described in the Development
Code. Location and time/duration of such sales/displays shall be reviewed and approved by the Community
Development Director or appointed designee.
Sidewalks at least six (6) feet in width shall be provided along all sides of the lot that abut a public ox private right-
of-way, excluding interstates. The Planning Commission may waive this requirement as pact of i development
agreement.
Continuous internal pedestrian walkways
sidewalk or right -of --way to the principal 'no less than five (5) feet in width, shall be provided from the public
customer entrance of all principal buildings on the site. At a minimum,
walkways shall connect focal points of pedestrian activity such as, but not limited m, transit stops,bs, benches,
street crossings,
budding and store entry points, and shall feature adjoining landscaped areas that include trees, shm
flower beds, ground coves, or other such materials to no less than 50 percent of their length.
Sidewalks, no less than five (5) feet in width, shall be provided along the full length of the building along any
facade featuring a customer entrance, and along any facade abutting public parking areas. Such sidewalks shall be
located at least six (6) feet from the facade of the building to provide planting beds for foundation landscaping,
except where features such as arcades or entryways are part of the facade.
Internal pedestrian walkways provided in conformance with Subsection b above, shall provide weather protection
features such as awnings or arcades within thirty (30) feet of all customer entrances, constructed parallel to the
facade of the building. This is not intended to extend into the driving aisles or parking areas.
All internal pedestrian walkways shall be distinguished from driving surfaces through the use of durable, low
maintenance surface materials such as pavers, bricks, or scored concrete to enhance pedestrian safety and comfort,
as well as the attractiveness of the walkways. Signs shall be installed to designate pedestrian walkways.
Each commercial establishment subject to these standards shall contribute to the establishment or enhancement
of pedestrian and public spaces by providing at least two (2) of the following: patio/seating area, pedestrian plaza
with benches, transportation center, window shopping walkways, outdoor play area, kiosk area, water Feature,
dock tower, steeple, or other such deliberately shaped area and/or a focal feature of amenity that, in the judgment
of the Planning Commission, adequately enhances such Community and public spaces. Any such areas shall have
direct access to the public sidewalk network and such features shall not be constructed of materials that are
inferior to the principal materials of the building and landscape.