The URL can be used to link to this page

Home My WebLink AboutAPPLICATION - 18-00260 - 175 W 2nd S - Five Guys Burgers and Fries - Tenant FinishCITY OF REXBURG America's Family Community BUILDING PERMIT FORM 1�91 Updated 03/2018 BUILDING APPLICATION Commercial Tenant Improvement Building Safety Department City of Rexburg 35 North 1St East Rexburg, Idaho 83440 For Office Use Permit Number: If �d0 Application Fee:Xl $100 1. Property Owner 4 Name: 1GG // Address: /�j z.. Z S City: 4. ,2 State: Z;d Zip Code: pyo Phone: Zd8. $ .f6 • 6/412 Emai : 2. Applicant / Name: S4." it Role: (Owner, Tenant, Contractor, etc.) Address: City: State: Zip Code: Phone: Email: Contact/Rep. Name: 3. General Contractor Under Idaho Building Code, a registered contractor must do the work for a Commercial Building. Name: LrDinSfra eAM Registration #: Q Lr- %6ZU-C Exp.: Address: City: L.e V4State: Zip Code: Phone: 4Email: -VAAw. e4o— Contact/Rep. Name: r+:. n s r- Phone: /. T! Email:. /- General Contractor Authorized Signature: Date: S7; A copy ofyour state registration/license is requ n 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 uns K9771yoimeficense is on file, please check with the Permit Technician by calling (208) 372-2341. 4. Project Description Address: Description of Work: 1. L Project Description: • Total cost of project - materials and labor: $ 300- ®d0 • Check all that apply: ❑ Mechanical: Cost $d ❑ Electrical: Cost $D ❑ Plumbing: Cost $ ❑ Fire Alarm: Cost $ie, ❑ Fire Sprinkler: Cost $ Note: Any contractors involved will need to fill out their respective application. • Change of Occupancy?,N No ❑ Yes: New occupancy: y ' Building Permit fees for commercial construction are charged based on square footage and the City's estimated valuation. The application fee applies toward the fee total. For details on how fees are calculated, contact the Building Department. There will also be a plan review fee totaling 10% of the building permit fee. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I 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 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): � M Signature: Date: Inspections must be cane before 8 AM on the day the inspection is requested. Inspecti e s called in after 8 AM will be scheduled for the next business day. Inspection Hotline - (208) 372.2344 www.rexburg.o Permit Technician - (208) 372.2341 C I TY OF REXBURG America' FamiFy 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. o APPROVAL OF CONSTRUCTION. 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 Initials 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) 372-2167. 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. o SCHEDULING INSPECTIONS. 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 nitials following business day. 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 put up, the inspector may require the sheetrock to be removed in order to perform the electrical rough in inspection.) o STAIRWAYS REQUIRED. On jobsites for multi-level buildings the contractor must provide temporary stairs so that workers and inspectors can safely access upper levels of the building. If these stairs are not provided, inspections may Initials not be completed. Extenuating circumstances will need to be approved by the Building Department. o DIGITAL AS -BUILT PLANS. A Certificate of Occupancy will not be issued without digital copies of the As -Built Plans. It is i the Applicant's responsibility to turn in digital copies of the As -Built Plans when the project is completed. No Certificate of Initials Occupancy will be issued without these plans, extenuating circumstances will need to be approved by the Building Department. J o OCCUPYING A FINISHED BUILDING. No building may be occupied without receiving a signed Certificate of Occupancy. If a building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the occupants may nitiais be required to vacate. o MAKING KNOWN POLICIES. 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. The above policies will be enforced to all, regardless if this Initials information is passed on to them or not. Applicant's Name (print): 4�," �J af,4,J ✓ Signature: Date: Inspections must be called in before 8 AM on the day the inspection is requested. Insp ction r uests called in after 8 AM will be scheduled for the next business day. Inspection Hotline — (208) 372.2344 www.rexburg.org L.,rermit Technician — (208) 372.2341 Revised 10/2016 ;^ r7 CITY O F REXBURG 01 America's 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: Firv6 (Ay, Name: pqr! hndh- Name: Damitii C I TY OF REXBURG America's Family Community BUSINESS USE SUMMARY Building Safety Department City of Rexburg 35 North 15t East Rexburg, Idaho 83440 The following questions will help speed the review process along. Please take the time to answer all of them. Is this business occupying an existing building? ,6Yes ❑ No Will the business be doing any structural/or remodeling changes to the building? ❑ Yes 16 No Any changes to the electrical? Q Yes ❑ No Any changes to the plumbing? Yes ❑ No Any changes to the mechanical system? Yes ❑ No Is the business type changing? ❑ Yes, it will change to /Yt�, / L.�� Q XNo Is this business changing ownership? ❑ Yes jk No Is the business registered with the City of Rexburg? ❑ Yes, License #: X No *If No, please apply for a business license with the Customer Service Dept. Will the business have food preparations? X Yes ❑ No Will there be any cooking of foods? XYes ❑ No Will there be any deep fat frying? XYes ❑ No Will you have food disposal on site? 'r ,Yes ❑ No Will there be sumps or floor drains in the facility? X Yes ❑ No Will the business have any chemicals on site? a l$ Yes ❑ No Z Sri- 'e17 ,#— 3 � 4 Phone Date I certify that the information that 1 have provided above is to the best of my knowledge accurate and true. Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 Revised March, 2016