HomeMy WebLinkAboutAPPLICATION 1 - 18-00468 - 50 Mill Race Rd - Attached Decko� VJ x O t'Rr,
CITY o > Building Safety Department
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xBuRG City of Rexburg
AruericasFamily Community 35 North 1St East
Rexburg, Idaho 83440
PERMIT POLICIES ACKNOWLEDGMENT
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.
Any construction within the City of Rexburg which requires a permit shall not begin until an approved permit is
obtained. If you do not have a Pink Building Permit signed by the Building Inspector, then you do not have an
approved permit.
o Building without the pink building permit signed by the Building Inspector will result in double fees to be
assessed and the project to be red tagged. If your project is red tagged, halting all construction, only a City
Initials Official may remove the red tag. If the red tag is removed by anyone but a City Official, citations may be
issued.
No building may be occupied without receiving a signed Certificate of Occupancy.
o If a building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the
occupants may be evicted.
Initials
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 following
business day.
o 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
Initials put up, the inspector may require the sheetrock to be removed in order to perform the electrical rough in
inspection.)
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 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) 372-2341.
o 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.
Initials
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.
o The above policies will be enforced to all, regardless if this information is passed on to them or not.
Initials
Applicant's Name (print): --�1� K Uc� Signature:.4d
Date: Z
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM will bescheduled for the next business day.
Inspection Hotline - (208) 372.2344 www.rexburg.org g B Permit Technician - (208) 372.2341 Revised 10/2016 _
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REXBU _ G City of Rexburg
� 35 North 1St
Anrias ! iunily Cornnnent13' East
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Rexburg, Idaho 83440
PROPERTY LINES
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 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
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
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Printed Name
Inspection Hotline - (208) 372.2344 www.rexburg.org
Permit Technician - (208) 372.2341 Revised 10/2016
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REX-BURG
BUILDING PERMIT FORM 404 City of Rexburg
- -- - Lw eud:,ed,o Zo,b 35 North 1st
A,»rr;c;ic Fin»ily Co»»nte»rt)' East
Rexburg, Idaho 83440
BUILDING APPLICATION
Residential Accessory Structure
For Office Use
Permit Number: Zoning:
Application Fee Paid: ❑ $100
1. Property Owner
Name:
. =LAd
Address:
Phone: �y_ Clty: Ce our State: Zip Code: _ B3 yq
(- Z- (� Email: >E x t
Under Idaho Building Code, a homeowner is allowed to do work on their own home. Q Q Gorv�
Are you a homeowner doing work on your own home?
®'Yes (Skip to #4 and complete the Homeowner's Exemption)
❑ No, I am a contractor working for the homeowner
2. Applicant
Name: _ 717 n_.r �zAtb.% Role:Owner, Tenant, Contractor, etc.)
Address: _ 7- Ci
Phone: ty' State: _fid Zip Code: �N�IZS
Email:_�r is2 .31 a7 gVrtQ�t
Contact/Rep. Name:
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
Structures less than 200 square feet do not need a building permit. Structures 200 square feet or larger need a building permit and
must adhere to the setback rules of the zone in which they, are built.
Address: A41 ,�J l� ��CJc,�
Pro' t D n '
)ec escrlptlon: In Ce
• Estimated Total Cost: $ Zlpc UCS
• Type of structure:
• Square Feet of Addition: "3c:!�
— sq. ft.
2 1Sck ❑ Garage/Car port ❑ Shed/Shop ❑ Other: Explain
• Check All Included in Scope of Work:
❑ Mechanical Work Cost: $ D ❑ Electrical Work Cost: $ C,
13 Plumbing Work Cost: $ d
Note: Any contractors involved will need to fill out their respective application.
Building Permit fees for accessory structures 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 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. 1 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
started within 180 days. Permit void if work stops for 180 days. void if not
Applicant's Name (print): �,�1 b'4AZ �,10 Signature: -
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 far the Date: --J6�1
Inspection Hotline - (208) 372.2344 business day.
www.rexburg.org Permit Technician - (208) 372.2341
c " 3 Y ° F Building Safety Department
REX-BURG City of Rexburg
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Amcriaa'sFandlvCa>unruuty 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.
Signature
/ z:`c 4Print Name
d
Date
Permit Technician - (208) 372.2341
www.rexburg.org Revised 10/2016
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REX-BURG City of Rexburg
AmeriatsFamilyConmunill 35 North 1St East
Rexburg, Idaho 83440
Affidavit of Legal Interest
State of Idaho
County of Madison I
71�2t A�PAt
Name f2 .1
Address
G
City
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, skip to B)
State
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 harmless from any claim or liability
resulting from any dispute as to the statements contained herein or as to the ownership of the property
which is the subject of the application.
Dated this -
day of v- 20 Z 8
Signature
Subscribed and sworn to before me the day and year first above written.
Notary Public of Idaho
Residing at:
My commission expires:
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
Revised 10, 2016
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C I T'- OF Building Safety Department
RE)MURG City of Rexburg
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A,nerirns 14anury torn,»,,,,r,,• 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