The URL can be used to link to this page

Home My WebLink AboutAPPLICATION - 18-00466 - 589 S Millhollow Rd - New SFR04 s�eUR� Ua 7 T� ��CI TnnYTTo�mFBuilding Safety Department R.1 �vv�13 RG BUILDING PERMIT FORM 2 30 City of Rexburg C)Wtnil 1st East Updated 03/2018 35 North 1 '<,„gyp ,.•' America's Family Community Rexburg, Idaho 83440 BUILDING APPLICATION Commercial Plumbing For Office Use Permit Number: Plumbing Fees Paid ❑ 2. Property Owner Name: )N (,k)p062TJW Address: & z 5' G q �, 7M>�n�3 Z� Phone: Sfi 20 City:1�� --C�1 Ti�L(% State: �_ Zip Code: �t(� (� �{ft� Lo Email: D 5�� .�/A 1�D0. GO✓"1 2. Plumbing Contractor Under Idaho Building Code, a registered contractor must do the work for a Commercial Building. Business: _ ' X,(21 n"( -low\ t�►M i 1`� y - State License #: Address: Exp.: Phone: City: 2( State: I �_ Zip Code: 3814 p Email: Contact/Rep. Name: Phone: Email: Plumbing Contractor Authorized Signature: 57 ZI file. If this is the first timeyou have done work in the City of Rexburg, please pride A copy ofyour state registration/license is required to be on a photo copy ofyour license. If you are unsure if your license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address: rj t9 C_.M i LL L Z rl Description of work: _ N O(AJ (AN WW GTIfl,4 ❑ Project Cost: $ *vG 4cii (0 00 Cost of project: Calculation for inspection fee: If project cost is between $0 to $10,000 then: ((-ost of project * 2%) + $60 If project cost is between $10,001 to $100,000 then: (((-ost of project - $10, 000) * 1 %) + $260 Ifproject cost is greater than $100,001 then: ((Cost ofproject - $100, 000) * 36 oa) + $1160 An additional plan review fee is required which is 1096 of the calculated inspection 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 swearthat 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): 12A4 Signature: a ` 0' 11 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 Oe V a R0 rd CITY or. Building Safety Department °BUILDING PERMIT FORM City of Rexburg REXIiURG CW Updated 03/2018 O ~' •, America's Family Community 35 North 1st East Rexburg, Idaho 83440 BUILDING APPLICATION Commercial Mechanical For Office Use Permit Number: 1. Property Owner Name: UYl(. tclld aTFe RVDP e T -) y 5 Address: Jl2.S &: A14yKM j- City: Phone: --2,D • e4oc- 'gona., 2. Mechanical Contractor Mechanical Fees Paid ❑ ,�z�c��_ —Pa� ay State: �_ Zip Code: _�3I _ 9±-y Email: 12U5; Y M L I If,, 1a MQ2 onM Under Idaho Building Code, a registered contractor must do the work for a Commercial Building. Business: 1tit6 State License #: Address:Exp.; Phone: CIS'' (�� State: i �_ Zip Code: _93 Ll L!b Email: Contact/Rep. Name: Phon :i �,TA 41.JSTa>= Email: �XPt. C Mechanical Contractor Authorized Signature: Date: 5-. 29 A co • � �d py o fyourstate 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: Description of work: /4C_W 0(:2/4STRt)C1-10/.1 ❑ Project Cost: $ �I'''1(-)O Cost of project: If project cost is between $0 to $10,000 then. If project cost is between $10,001 to $100,000 then. If projectcost isgreater than $100,001 then: An additional plan review fee is required Calculation for inspection fee: (Cost of project * 2%) $$60 ((Cost of project $10, 000) * 1%)-$260 ((Cost ofproject - $100, _000)' �6 %) + $1160 is 10% of the calculated inspection 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): _ _-J f b !3 • <#4y Signature: 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 be scheduled for the next business day. Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 For Office Use Permit Number: CITY OF REXBURG CW America's Family Community BUILDING PERMIT FORM Z 2 Updated 03/2018 BUILDING APPLICATION Commercial Electrical Building Safety Department City of Rexburg 35 North 1St East Rexburg, Idaho 83440 Electrical Fees Paid ❑ 1. Property Owner Name: J%GWN02 _ PiQOPM--rltti Address: [#Z.S rL /gJ_AMPcDAk City: State: jyl� State: Zip Code: 53?,0) Phone: _7,679 • tJQU • 90O LR Email 0QS_ f M "e -A 2. Electrical Contractor RCF, _ ki 356 Under Idaho Building Code, a registered contractor must do the work for a Commercial Building. Business: L141 State License #: Z39 SV Exp.: 2� 1 Address: City: State:(S'-,Zip Code: Phone: Email: Contact/Rep. Name: Email: Electrical Contractor Authorized Signature: TIOV- vu = -Dater- (C� 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 photocopy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description ��jj 1 ' I 1 ^ S. Address: -H' 73�r Ism ..%,- Description of work: h:F 1l) /prl e?Q0T1gA4 ❑ Project Cost: $ _ `'_5 A 0 %,�- Cost of project: Calculation for inspection fee: If project cost is between $0 to $10,000 then: (Cost of project * 2%) + $60 If project cost is between $10, 001 to $100, 000 then: ((Cost of project - $10, 000) * 1 %) + $260 If project cost is greater than $100,001 then: ((Cost of project - $100, 000) *'6 %) + $1160 There will also be a plan review fee totaling 10% of the above fee. 11 -1 . 0 olurvn I Uno, Dare 1 1NUA t 1U ANL) AUTHUKIZATI0N: 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. 2r� 11 // AA Applicant's Name (print): /%Rf� J,J J�-,� Signature: / l 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 Ua 7 CITY OF building Safety Department REXBURG City of Rexburg N' America's Family Community ` 35 North 1St East '<,,x o ,.•` l Rexburg, Idaho 83440 SUBCONTRACTOR LIST Excavation & Earthwork: _ K A Q Concrete: re � i N VF— G'p, � Masonry: Roofing: Insulation:J)Vf}NCn Drywall: Painting:.. Pi2G PA/,t41 Floor Coverings: 1%%JI V R A rLQ?�/NCy Plumbing: AOR- A PIA 9v R I AJ i•, Heating: Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses: ,�jf�(q K iZ\ Vh tZ T -x L9 s S m S m c Floor/Ceiling Joists: _2� YV\ C. Siding/Exterior Trim: Other: Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 Revised 10/2016