HomeMy WebLinkAboutAPPLICATION 1 - 18-00310 - 1450 N 2nd E - Walmart - Fitting Room/Photo Lab Remodelct �t.x u vkC
r� CITY o F
REXBURG
Arncricn's Family Community
BUSINESS USE SUMMARY
Building Safety Department
City of Rexburg
35 North 1st 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? M 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
M No
Any changes to the mechanical system?
❑ Yes
® No
Is the business type changing? ❑ Yes, it will change to
m No
Is this business changing ownership?
❑ Yes
® No
Is the business registered with the City of Rexburg? ® Yes, License #:
❑ No
*If No, please apply for a business license with the Customer Service Dept.
Will the business have food preparations?
❑ Yes
® No
Will there be any cooking of foods?
❑ Yes
® No
Will there be any deep fat frying?
❑ Yes
® No
Will you have food disposal on site?
❑ Yes
® No
Will there be sumps or floor drains in the facility?
❑ Yes
IN No
Will the business have any chemicals on site?
❑ Yes
R No
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Applicants Signature Phone Date
I certify that the information that I 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
CITY OF
R.EXBURG
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America's Family C,ammunily
BUILDING PERMIT FORM 2 1
Updated 10/2016
BUILDING APPLICATION
Commercial Remodel
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
For Office Use
Permit Number: Application Fee: ❑ $100
1. Property Owner
Name: Walmart Real Estate
Address: 2001 SE Tenth ST Bentonville
Phone: 479-273-4000 City: State: AR Zip Code: 72712
Email: david.ewing@walmart.com
2. Applicant
Name: pb2 architecture +engineering Role: (Owner, Tenant, Contractor, etc.) applicant for owner
Address: 2809 Ajax Ave, Ste 100 City; Rogers State: AR Zip Code: 72758
Phone: 479-878-3530 Email: heather.edmistonopb2ae.com
Contact/Rep. Name: Heather Edmiston
3. General Contractor
Under Idaho Building Code, a registered contractor must do the work for a Commercial Building.
Name: tbd Registration #: Exp.:
Address: City: State: Zip Code:
Phone: Email:
Contact/Rep. Name: Phone: Email:
General Contractor Authorized Signature: Date:
A copy ofyour state registration/license is required to be on 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 unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
4. Project Description
Address: 1450 N. 2nd E
Description of Work: remove and add new apparel fixtures; remove/replace fitting rooms;
Project Description: add power to fitting rooms, necessary apparel fixtures, electronics, and new photo lab
• Total cost of project - materials and labor: $ 30,000.00
• Check all that apply:
❑ Mechanical: Cost $ ® Electrical: Cost $ 20,000.00 ❑ Plumbing: Cost $
❑ Fire Alarm: Cost $ ❑ Fire Sprinkler: Cost $
Note: Any contractors involved will need to fill out their respective application.
• Change of Occupancy? IN No ❑ Yes: New occupancy:
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 10916 of the building permit fee.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, l 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): Heather Edmiston
Signature: 4ha�,__ Date: � - (10,111
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM will be scheduled for the next business day.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341