HomeMy WebLinkAboutAPPLICATIONS & RECEIPT - 18-00345 - 300 Baldwin Dr - SFR Basement FinishCITY OF
REXBURG
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Americas Family Community
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Building Safety Department
City of Rexburg
35 North 1St East
Idaho 83440
SINGLE FAMILY RESIDENTIAL BASEMENT FINISH APPLICATION CHECKLIST
The following items should be completed before you submit your building permit application.
*Reasonable accommodations will be made upon request.
Submit the Following Documents:
❑ 2 sets of building plans drawn to scale
❑ Floor Plan, Sectional Views, Mechanical Layout, Stair Details, and any details required to illustrate special
construction.
❑ Digital Plans (PDF Format - can be submitted by USB, CD, or Dropbox)
❑ **Copies of any Contractors' State License if not on file already.
Complete the Following Forms:
❑ Permit Policies Acknowledgment signed.
❑ Building Permit Application signed by a registered General Contractor.
❑ Mechanical Permit Application signed by a registered Mechanical Contractor.
❑ Electrical Permit Application signed by a registered Electrical Contractor.
❑ Plumbing Permit Application signed by a registered Plumbing Contractor.
❑ Subcontractor list completed.
❑ Homeowner's Exemption signed, if Homeowner is doing work on their own home.
❑ Affidavit of Legal Interest signed by owner, if applicant is not working directly with owner.
❑ Notifications Distribution List.
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 at httn: //rexburg org/p_ages/development code.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
Revised 10/2016
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City of Rexburg
"•<, �Fo America's Family Community PERMIT POLICIES ACKNOWLEDGMENT 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
Initials 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
initiais not be completed. Extenuating circumstances will need to be approved by the Building Department.
o DIGITAL A5 -BUILT PLANS. A Certificate of Occupancy will not be issued without digital copies of the As -Built Plans. It is
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.
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
rials 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
initiais information is passed on to them or not.
Applicant's Name (print): ✓� Signature: a/
Date: /
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
Revised 10/2016
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.� ' 1EXBy1tG BUILDING PERMIT FORM 104 City of Rexburg
Updated 10otb 35 North 1St East
America's Family Community
Rexburg, Idaho 83440
BUILDING APPLICATION
Single Family Residence Basement Finish
For Office Use
Permit Number: 0'O 3�
Application Fee Paid: $100 I &1/
1. Property Owner
Name: _ .ti 7rC P14 4 H 19 13j4 -"f 61k
Address: 3cp_> t3,tLJ wry 2 Ci kt�_ jc
t3' — State: —.L Zip Code: -a YV f
Phone: ?.c> s yy 7'7 Via / Email: gZ:Z;r a+112A4Cd�v/1t1�-r C?
Under Idaho Building Code, a homeowner is allowed to do work on their own home.
Are you a homeowner doing work on your own home?
X_Yes (Skip to #4 and complete the Homeowner's Exemption)
❑ No, I am working with the homeowner
2. Applicant
Name: Role: (Owner, Tenant, Contractor, etc.)
Address:
City: State: Zip Code:
Phone:
Contact/Rep. Name: Email:
3. General Contractor
Name: Registration #:
Address: Exp.:
Phone:
City: State: Zip Code:
Email:
Contact/Rep. Name: Phone:
Email:
General Contractor Authorized Signature:
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: 3c�)P 3645 L-kt
Project Description: _151til�S1� Q/FS •e,i�r j`
• Square Footage being Finished: YOU sq. ft.
• Check All Included in Scope of Work:
❑ Mechanical Work CCElectrical Work aPlumbing Work
Note: Any contractors involved will need to fill out their respective application.
• Fireplace(s) Being Installed? ❑ Yes X No
Building Permit fees for new homes are charged based on square footage and the City's estimated valuation. 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 1 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): Signature: .• Date:
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
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Americas Family Community 35 North 1St East
Rexburg, Idaho 83440
DISTRIBUTION LIST
Please provide the names and emails of anyone who should begetting automated updates for this project:
Review Notes
Name:
Name:
Name:
Name:
Name:
Inspection Tickets
Name:
Name:
Name:
Name:
Name:
Email:
Email:
Email:
Email:
Email:
Email:
Email:
Email:
Email:
Email:
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
Revised 10/2016
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1EXByRG City of Rexburg
America' Family Community 35 North 1St East
Rexburg, Idaho 83440
HOMEOWNER'S EXEMPTION
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 fill out this form showing your
exemption and send it with your permit application.
Idaho State Statute allows a homeowner to do work on their own residence:
An owner performing construction on the owner's personal residential real property, whether or not occupied by
the owner, provided however, this exemption shall not apply to an owner who is otherwise regulated by this chapter
who constructs a building, residence or other improvement on the owner's property with the intention and for the
purpose of promptly selling the improved property, unless the owner has continuously occupied the property as the
owner's primary residence for not less than twelve (12) months prior to the sale of such property;
Title 54, Chapter 52, Subsection (2)
I hereby certify that the above information is true and correct to the best of my knowledge.
r'
Signature
Print Name
Date
Permit Technician - (208) 372.2341 www.rexburg.org
Revised 10/2016
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RExBuRGr City of Rexburg
AmericasFam yCommunity 35 North 1St East
Rexburg, Idaho 83440
SUBCONTRACTOR LIST
Excavation & Earthwork:
Concrete:
Masonry:
Roofing:
Insulation:
Drywall:
Painting:
Floor Coverings:
Plumbing: _ 14o L
Heating:
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses:
Floor/Ceiling Joists: _
Siding/Exterior Trim:
Other:
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
Revised 10/2016
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° City of Rexburg
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America's Family Community 35 North 1St East
Rexburg, Idaho 83440
BUILDING APPLICATION
SFR Basement Finish Plumbing
For Office Use
Permit Number:
0 Plumbing Fee Paid
1. Property Owner
Name : T[�,Arl�r ✓� i�4 k:¢at
Address: _3<)� i3,44 t� l ,tf
;�_ City: Ja�T K%'u:, State: _I Zip Code: r,. s YY0
Phone: --'.o6 35;c)7,7,i` Email: ,s IEP#Zy ,, i3✓�ieZ CLIMB. Ic, c c�
Under Idaho Building Code, a homeowner is allowed to do work on their own home.
Are you a homeowner doing work on your own home?
[Yes (Skip to #3 and complete the Homeowner's Exemption)
0 No, I am working with the homeowner
2. Plumbing Contractor
Business: State License #:
Address: Exp.:
Phone: City: State: _ Zip Code:
Contact/Rep. Name: Phone: Email:
Email:
Plumbing 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.
3. Project Description
Address: ?cam`, i314LA �.� Jj
Description of work: /�I MlSrF 13,3��
0 SFR Construction: iNIJ sq. ft.
• Fees for additions are charged by square footage: Up to 1,500 sq. f. = $130 + $65 for each additional 1,000 sq. ft. or portion
thereof.
Square Footage Total Cost
Up to 1, 500 sq. ft. $130
Up to Z 500 sq. ft. $195
Up to 3,500 sq. ft. $260
Up to 4500 sq. ft $325
Add $65 per additional thousand sq. ft
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): ,S Z]Ep#* f Signature: /�j..' �^""
Date: .46
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
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UIQ1�,1� V RG BUILDING PERMIT dFORM 12 3 city of Rexburg
''�►'i -d 03/2018
America' Family Community 35 North 1St East
Rexburg, Idaho 83440
BUILDING APPLICATION
F B m n Fini h EI ri 1
For Office Use
Permit Number:
❑ Electrical Fee Paid
1. Property Owner
Name: ,a 7 f,n/4 te-.v
Address:;; cY.7 i}Lt7 z�wr y� 2 City: _l�X B c .ttY
State: A— Zip Code:
Phone: 4, zC 77StI' Email:
Under Idaho Building Code, a homeowner is allowed to do work on their own home.
Are you a homeowner doing work on your own home?
%Yes (Skip to #3 and complete the Homeowner's Exemption)
❑ No, I am working with the homeowner
2. Electrical Contractor
Business: State License #:
Address: Exp.:
Phone:
City: State: _ Zip Code:
Email:
Contact/Rep. Name: Phone:
Email:
Electrical Contractor Authorized Signature:
Date:
A copy ofyour state registration/license is required to be on file. If this is the first timeyou 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.
3. Project Description
Address: JrA2 3AL,I:) w,K-f A OZ_
Description of work: E1 A( 1 &Vd;t4-,k-1
4—
❑ SFR Construction: sq. ft.
• Fees for additions are charged bysquare footage: Up to 1,500 sq. ft = $130 + $65 for each additional 1,000 sq, ft. or portion
thereof.
Square Footage Total Cost
Up to 1, 500 sq. ft $130
Up to 2, 500 sq. ft. $195
Up to 3, 500 sq, ft $260
Up to 4500 sq. ft $325
Add $65 per additional thousand sq. ft
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I have read this application and state thatthe information herein
is correct and I swear that any information which may hereafter be given by mein 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): c ;7 A",,- j1, r3% 3 Signature: ' =r
----� Date: 6- 6 /
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
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0 REXBURG BUILDING PERMIT FORM113 City of Rexburg
(-W Updated 03/2018
• ,, America' Family Community 35 North 1St East
Rexburg, Idaho 83440
BUILDING APPLICATION
n Fini h FR M h ni al
For Office [Jse
Permit Number:
❑ Mechanical Fee Paid
1. Property Owner
Name: _.2-,6t)il4V I
Address: Sergi �:�4t p ;1�„� city:-�' — State: — Zip Code: S Q
Phone: _'C',> Cy 7?,� Email: ter �_
Under Idaho Building Code, a homeowner is allowed to do work on their own�om ���� � C2 MAI(_
cc,�
Are you a homeowner doing work on your own home?
[XYes (Skip to 43 and complete the Homeowner's Exemption)
❑ No, I am working with the homeowner
2. Mechanical Contractor
Business: State License #:
Address: Exp.:
Phone:
City: State: Zip Code:
Email:
Contact/Rep. Name: Phone:
Email:
Mechanical Contractor Authorized Signature:
A copy ofyour state registration/license is required to be on file. If this is the first timeyou 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.
3. Project Description
Address:.3c� j ,^•„� ��w�i 7 ,� ,�{
Description of work: /'I uCi'1f 3A,E, •,u,E,(4-1—
❑ SFR Construction: flv zj sq. ft.
• Fees for additions are charged bysquare footage.• Up to 1,500 sq. ft = $130 + $65 for each additional 1,000 sq. ft. or portion
thereof.
Square Footage Total Cost
Up to 1,500 sq. ft $130
Up to 2, 500 sq. ft. $195
Up to 3, 500 sq. ft. $260
Up to 4500 sq. ft $325
Add $65 per additional thousand sq. ft
❑ Number of Fireplaces: _
• Note that fireplaces are not included in square footage costs and will be charged $65 per inspection as shown below.
c ❑ Built-in $130 ❑ Free-standing $65
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that 1 have read this application and state that the information
herein is correct and 1 swear that any information which may hereafter be given by mein 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): t' fact Signature: ``��
Date: fib- / a
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
Xpress Bill Pay - Payment Processing
REXBURG
W
XBP Confirmation Number: 45542400
https://secure.xpressbillpay.com/common/payment_process.php
City of Rexburg
35 N 1st East I PO Box 280
Rexburg, ID 83440
208-359-3020
ub@rexburg.org
4 Transaction detail for payment to City of Rexburg.
Transaction Number: 86787994PT
Visa — XXXX-XXXX-XXXX-8949
Status: Successful
ccount # Item_ -._. _ ___
Quantity
Building Permit 1
Mechanical Permit 1
Electrical Permit 1
BP CC Conv. Fee 1
Notes: Building Permit 18-00345 Basement Finish 300 Baldwin
Billing Information
Stephen Bakes
,83440
stephen.bakes@gmail.com
lofl
Date: 06/26/2018 -11:27:28 AM!
I
I
Item Amount
$413.00
$130.00
$130.00
$21.00
TOTAL: $694.00
Transaction taken by: porterw
6/26/2018, 11:25 AM