HomeMy WebLinkAboutAPPLICATIONS - 18-00522 - 106 E 1st N - Rockhouse AdditionCITY OF
REXBURG
Amenwi Family Community
Building Safety Department
City of Rexburg
35 North lst East
Rexburg, Idaho 83440
COMMERCIAL REMODEL/TENANT IMPROVEMENT APPLICATION CHECKLIST
The following items should be completed before you submit your building permit application.
*Reasonable accommodations will be made ul2on re uest.
Submit the Following Documents:
❑ 3 sets of building plans - stamped by a licensed professional.
Include the following as applicable
❑ Foundation Plan, Floor Joist Layout, Floor Plan, Roof Layout, Truss Details, Sectional Views, Front Back, and Side
Elevations, Mechanical Layout, Stair Details, and any details required to illustrate special construction.
❑ Electrical panel layout and calculations included with building plans.
❑ Exterior Lighting Plan including photometric layout.
❑ Structural Calculations (if applicable) -stamped by a licensed Engineer
❑ Digital Plans (PDF Format- can be submitted by USB, CD, or Dropbox)
4 "Copies of any Contractors' State License if not on file already.
Complete the Following Forms
to Permit Policies Acknowledgment signed
`l( Building Permit Application signed by a registered General Contractor
it Mechanical Permit Application signed by a registered Mechanical Contractor
9' Electrical Permit Application signed by a licensed Electrical Contractor
2f. Plumbing Permit Application signed by a licensed Plumbing Contractor
X Fire Alarm Permit Application (if applicable) signed by a registered professional
Fire Sprinkler Permit Application (if applicable signed by a registered professional
Subcontractor list filled out
❑ Affidavit of Legal Interest signed by owner
X Notifications Distribution List
1> Business Use Summary Completed
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 athttl2://rexburg.org/12ages/development-code.
/
Inspection Hotline -(208)372.2344 www.rexhurg.org Permit Technician -(208)372.2341 Revised 10/2016
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4, ,ted CITY OF
nT Building Safety Department
m 1� C G City of Rexburg
Amerfwd Family Community PERMIT POLICIES ACKNOWLEDGMENT 35 North 1st East
Rexburg, Idaho 83440
nTheCity of Rexburg Building Safety Department is determined to provide excellent customer service. In an effort to help you
derstand the City of Rexburg Permit Policies, listed below are several policies which you are required to know prior to
proceeding with your Droiert_
o APPROVAL OF CONSTRUCTION. Construction on any project can begin 0 LY 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.
p qP I 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
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
the Applicant's responsibility to turn in digital copies of the As -Built Plans when the project is completed. No Certificate of
Ini 'ais Occupancy will be issued without these plans, extenuating circumstances will need to be approved by the Building
Department.
\U o OCCUPYING A FINISHED BUILDING. No building may be occupied without receiving a signed Certificate of Occupancy. If a
VV building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the occupants may
ini als be required to vacate.
❑oMAKI NG K N 0 W N POLICI ES. 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
inib Is information is passed on to them or not.
Applicant's Name (print): (�- �I Signature:
Inspections must be called in before 8 AM on the day the inspection is
Inspection Hotline - (208) 372.2344
www.rexburg.org
Date:1, `0 ��
called in after 8 AM will be scheduled for the next business day.
hnician-(208)372.2341 Revised 10/2016
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GIT'' OF Building Safety Department
REXIiURG
" BUILDING PERMIT FORM Z 1 City of Rexburg
n ptlau'°'r'°taommunity
Amerimi Fami35 North 1st East
ly C
Rexburg, Idaho 83440
BUILDING APPLICATION
Commercial Remodel
For Office Use
Permit Number:
Application Fee: ❑ $100
1. Propertv Own r
Name:
Address:
Phone:- City:Mn" State: Zip Cod
Email:
2. Applica
Name;Addre5 Rol CO net, Tenant, Contracto etc.)
Phoneys - _ p City: tate: Zip C de:
Contact/Rep. Name: d Email:
r
3. General Contractor
Under I ho Building Code, a registered contractor must do the work for a Commercial Building,
Name: �.. \ -P)1� Registration #: E - s(Q Exp.: I?
k
Address:
Phone: - 0 _ �$ D CIty`� State: Zip Code: Z
Email: �
Contact/Rep. Name; (Q, hone - _
General Contractor Authorized Signature: / - o
Date:
py fyourstate registration /license is require o be on f(e. !f this r the s tmeyou have done work in the City of Rexburg, please provide
o 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 c L
Address: Lok C T
Description of Work: 6trL
Project Description: \� `
• Total cost of project - materials and labor: $
• Check all that apply:!
4 Mechanical: Cost $1W'! Electrical:Cost $�U Plumbing:Cost$},��ll�
ID Fire Alarm: Cost$ ❑ Fire Sprinkler: Cost$
Nate: Any contractors involved will need to fill out their respective application.
• Change of Occupancy?IA' 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 10% of the building permit fee.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury, I hereby certify that l 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. 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: Thebuildin 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 applicatio r on the plans on which the permit orapproval was based. Permitvoidifnot
started within 180 days. Permit void if work stops for 180 days.
Applicant's Name (print): �• I' Signature: R -f 7-lB
Date:
Inspections must be called in before 8 AM on the day the inspection is requested. Inspect. requests called in akere 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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TCD LLC KLINGLER, ET AL
ILDERS
166g HIGHLANDS ASHTON ID 83420 AD
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CITY OF Building Safety Department
BUILDING PERMIT FORM 210 City of Rexburg
"" °"° "°"'°'a 35 North 1st East
Americas Family Community
Rexburg, Idaho 83440
BUILDING APPLICATION
Commercial Mechanical
For Office Use
Permit Number: Mechanical Fees Paid ❑
1. Property Owner
Name: �- I, h
Address S� City: — ,k� Stater Zip Cgde i l]
Phone: 0'1� Email: Cp Pin (� vea lc m l �^9 ('tD 'C � 0 dVvs
2. Mechanical Contractor
Under IdahR Building Code, a registered contractor must do the work for a Commercial Building
Business: Ke w iotad. c�_ State License#: Exp.: a- 30' 2�
Address: :1(,2X 7 City: Stat�Zip Code: ts O
Phone: LO $ - .3 s56 — $ 7 7 Email:
Contact/Rep. Name: &c,Phone:
nn Email:
Mechanical Contractor Authorized Signature: `(r. Y-1/ Dater
A copy ofyour state registration/license is required to be onffle. Ifthis i effrst Hineyou have done work in the City of Rexbur,ple spprovide
a photocopy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
3. Projeci
Address:
Descripti
rrojec
1
Cost of project:
Calculation for inspection fee:
Ifprojectcostis between $0 to $10,000 then:
(Costo)'project'2%)+$60
Ifprojectcostis between $10,001 to$100,000 then:
((Cost of project -$10,000)*1%)+$260
Ifproject cost is greater than -$l 00,00 ahem
A.. .. J -RJ — ,-.----. n ..
((C0st0fprr0ject-$100,000)°4696)+$1160
--- - -
•• • ......u... cnewlee to required which is a* of the calculated inspection fee
-------•-•-........ ......... ..— rims nu, -�meni lum under penalty ofperjury,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 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. Permitvoidifnot
started within 180 days. Permit void if work stops for 180 days.
Applicant's Name (print): ;YA� 6 11"p 1
Inspections must be called in before 8 AM on the day the inspection is requested. Inspecti
Inspection Hotline- (2 08) 372.2344 wwev.uxburg.org
Date:
in after 8 AM will be scheduled for the next business day.
Permit Technician - (2 08) 372.2341
Foo °axe e�., 1�� n�CITY n�o F Building Safety Department
�Y `Klo 1�aL�.t�U1\G BUILDING PERMIT FORM220 City of Rexburg
ry "'a° °a/2018 35 North 1st East
Amerfm7 Family Community Rexburg, Idaho 83440
BUILDING APPLICATION
Commercial Electrical
For Office Use
Permit Number: Electrical Fees Paid ❑
Name:
( NO)
N C. InV\
Name: I l r
Address: i �5� City;
Phone: —S4000 Email:
2. Electrical Contractor
Under Idaho B� �Idi!7 Code, a registered contractor must do the work for a Commercial Building.
Business: V/QGia �L�cr' tc_ State License#: C- -2 Ex 8 347
Address: /l/ No C�NTe4— Ci EXIdao State: p' 3Y40
city: � � Zip Code: IG'
Phone: 2-0E- L? -/??0 Email: Jcly !i cw _J",[ C,4r
Contact/Rep. Name: iz+Y f4c la Phone: / ail:
Electrical Contractor Authorized Signature; Date:
A copy ofyour state registration/license is required to be qojarffthis is Chefirst timeyou 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. Projecl
Address:
Descripti
*rojec
There will also be a plan review fee totaling 10% of the above fee.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury,Ihereby certify that l have read this application and state that the 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 factin the application or on the plans on which the permit or approval was based. Permitvoidifnot
started within 180 days. Permit void ifwork stops for 180 days.
—1 1
Applicant's Name (print):- I�{,�'14 L—A LX Signature:
Inspections must be called in before 8 AM on the day the inspection is requested. Inspecti
Inspection Hotline - (208) 372.2344 www.rexburg.org
Date: -/ter
in after 8 AM will be scheduled for the next business day.
Permit Technician - (208) 372.2341
Cost of project:
Calculation for inspection fee:
If project cost is between $0 to $10,000 then:
(Cost of project' 2%) + $60
Ifproject cost is between $10,001 to$100,000 then:
((Cost ofproject-$10,000)'1%)+$260
Ifproject cost is greater than $100,001 then:
((Cost ofproject-$100,000)"'/%)+$1160
There will also be a plan review fee totaling 10% of the above fee.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury,Ihereby certify that l have read this application and state that the 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 factin the application or on the plans on which the permit or approval was based. Permitvoidifnot
started within 180 days. Permit void ifwork stops for 180 days.
—1 1
Applicant's Name (print):- I�{,�'14 L—A LX Signature:
Inspections must be called in before 8 AM on the day the inspection is requested. Inspecti
Inspection Hotline - (208) 372.2344 www.rexburg.org
Date: -/ter
in after 8 AM will be scheduled for the next business day.
Permit Technician - (208) 372.2341
fia 4suxauq�`e 7�7 CITYYY OF Building Safety Department
Bio 1�G BUILDING PERMIT FORM City of Rexburg
cti Updated D3/2018 35 North 181 East
Americas Family Community
Rexburg, Idaho 83440
BUILDING APPLICATION
Commercial Plumbing
For Office Use
Permit Number: Plumbing Fees Paid ❑
1. Propewner
Name:
Address:JU
S NI City: State: Zip ode:
Phone: — - Email:
2. Plumbing Contractor
Under Idaho Building Code, reg ijtered contractor must do the work for aCommercial Building.
Business: t�`�J��9 / l� n fJ I •t a t��a �,/ State License #: ��( Ica - /3`%99Exp.:
Address: U• J ox i S % Jr City: b" State: 37� Zip Code: g3
Phone: YM- O Email:
Contact/Rep. Name: <O Phone: Email:
i
Plumbing Contractor Authorized Signature: " Date: e"
A copy afyourstate registration/license is required to be on file. If this is the first threyou have done work in the City ofRexbu g, pease 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
Address:
Descripti
1$ Projecl
An additional plan review fee is required which is 10% of the calculated inspection fee
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury, I hereby certify that l have read this application and state that the 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 Iagree to comply with all City regulations and State laws relating to the subject matter ofthis application and hereby authorized representatives ofthe
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. Permitvoidifnot
started within 180 days. Permit void ifwork stops for 180 days.
Applicant's Name (print . 11- I Signature:
Inspections mus[ be called in before 8 AM on the day the inspection is requested. Inspection
Inspection Hotline - (208) 372.2344 www.rexburg.org
in after 8 AM will be scheduled for the next business day.
Permit Technician - (208) 372.2341
Cost of project:
Calculation for inspection fee:
If project cost is between $0 to $10,000 then:
(Cost oleproject * 2%) + $60
Ifproject cost is between $10,001 to $100,000 then:
((Costofproject-$10,000)*1%)+$260
Ifproject cost isgreater than $100,001 then:
((Costofproject-$100,000)*;i%)+$1160
An additional plan review fee is required which is 10% of the calculated inspection fee
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury, I hereby certify that l have read this application and state that the 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 Iagree to comply with all City regulations and State laws relating to the subject matter ofthis application and hereby authorized representatives ofthe
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. Permitvoidifnot
started within 180 days. Permit void ifwork stops for 180 days.
Applicant's Name (print . 11- I Signature:
Inspections mus[ be called in before 8 AM on the day the inspection is requested. Inspection
Inspection Hotline - (208) 372.2344 www.rexburg.org
in after 8 AM will be scheduled for the next business day.
Permit Technician - (208) 372.2341
0 CITY OF Building Safety Department
RM BUILDING PERMIT FORM 4,02 City of Rexburg
CW °°'a" °° 35 North 1st East
Amenrut Family Community Rexburg, Idaho 83440
BUILDING APPLICATION
Fire Sprinkler N `k
For Office Use
Permit Number:
Fire Sprinkler Fees Paid ❑
1. Property Owner
1%+260
Name:
.596 + 1,160
Address: City:
State: Zip Code: _
Phone: Email:
2. Contractor
Business: State License #:
Exp.:
Address: City:
State: Zip Code:
Phone: Email:
Contact/Rep. Name: Phone:
Email:
Contractor Authorized Signature:
Date:
-
A copy ofyourstate 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:
Number of Heads:
❑ Fire Sprinkler System Cost: $
• Fees for remodels are charge by cost:
INITIAL COST
CHARGE BY COST
Up to $10,000
2%+$60
0 i.e. Work costing $15,000 will be charged $260 far the first $10,000 and 1% of the remaining $5,000 = $260 +$50 =
$310 total fee
• There will also be a plan review fee totaling 10% of the above fee.
Date: IN7—
=
Up to $100,000 =
1%+260
Above $100,000 =
.596 + 1,160
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that l have read this application and state that the information herein
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. Permitvoidifnot
started within 180 days. Permit void if work stops for 180 days.
Applicant's Name (print):,T (..� Signature:
Inspections must be called in before 8 AM on the day the inspection is requested. InspeAlml
Inspection Hotline - (208) 372.2344 www.rexburg.org
�
in after
a AM will be scheduled for the next business day.
Permit Technician - (206) 372.2341
°e µ[zaUgC
CITY OF Building Safety Department
BUILDING PERMIT FORM 4,01 City of Rexburg
(Ly UN'. to/znts
Anrerfms Mnay ronmemay 35 North 1St East
BUILDING APPLICATION
Fire Alarm
For Office Use
Permit Number:
I. Property Ownel
Name: UJ � Q
Address:
Phone: Clty.
Email:
2. Contractor
Contact/Rep. Name:
City:
Phone:
Email;
Rexburg, Idaho 83440
Fire Alarm Fees Paid ❑
Exp.:
Zip Code:
a
l.ul&`actor kfh4lurrzed Jlgfrrtfure:
A copy ofyour state registration/license is required to be on file. If this is the first timeyou have done work n the City of Rexburg, please provide
a photo copy ofyour license. ifyou are unsure iifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
3. Project Descrintion.
ascription of work: _ W
Fire Alarm System Cost:
Fees for fire alarm systems are charge by cost..
0 Ffrst$10,000=2%+$60. From $10,000 to$100,000=1%+$260.Above$100,000=.5%+$1,160. i.e. Workcosting
$15,000 will be charged $260for the first$10,000 and 1 % of the remaining $5,000 = $260+$50 = $310 total f�
There will also be a plan review fee totaling 10% of the above fee.
.APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofpetjury, I herebycertifythat l have read this application and state that the information herein
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 Scale laws relating to the subject matterof this application and herebyauthurized representatives of the City
to enter upon the above-mentioned property for inspecaom purposes NOTE: The building official may revoke a permit on approval issued under the provisions of the 2012
International Code in cases of any Use statement or misrepresentation of fact In the application or on the plans on which the permit or approval was based. Permitvoidifnat
started within 180 days. Permit void if work stops for 180 days.
Applicant's Name (print): Signature:
Date: - Z. 2�
Inspections must be called in before 8 AM on the day the inspection is requested. InspecU requests called in after 8 AM will be scheduled for the nett business day.
Inspection Hotline - (208) 372.2344
www.rexburg.org Permit Technician - (208) 372.2341
µaxaup
CITY OF
'S
REXBURG
America's Family Community
Excavatio
Concrete:
Masonry:
Roofing: _
Insula
Dryw:
Painti
Floor
Plumt
Heatit
Electr
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
SUBCONTRACTOR LIST
Special Construction
�AA (Manufacturer or Supplier)
Roof Trusses: Nkc, -
Floor/Ceiling Joists:
Siding/Exterior Trim: I WV
Other:
Inspection H othne - (208) 3 72.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised 10/2016
CITY OF
REXBURG
CW
America'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 thein.
Is this business occupying an existing building?
Will the business be doing any structural/or remodeling changes to the building?
Any changes to the electrical?
Any changes to the plumbing?
Any changes to the mechanical system?
Is the business type changing? o Yes, it will change to
Is this business changing ownership?
Is the business registered with the City of Rexburg?p(Yes, License #:
*If No, please apply for a business license with the Customer Service Dept.
Will the business have food preparations?
Will there be any cooking of foods?
Will there be any deep fat frying?
Will you have food disposal on site?
Will there be sumps or floor drains in the facility?
Will the business have any chemicals on site?
2c�35/o-51aq—1>-1S�
Phone Date
HYes ❑ No
p4es ❑ No
01 es ❑ No
,!(Yes ❑ No
5As ❑ NN/O
21l 0
13 Yes `IN0
❑ No
El Yes Oho
❑ Yes tr' o
[]Yes D40
❑ Yes .18No
13 Yes t..5//No
El Yes b No
I certify that the information that l have provided above is to the best of my knowledge accurate and true.
Inspection Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised March, 2016
CITY OF
REXBURG
OW -
America's Family Community
DISTRIBUTION LIST
Building Safety Department
City of Rexburg
35 North 1st East
RexburE, Idaho 83440
Please provide the names and emails of anyone who should begetting automated updates for this project.
Review Notes
Name:��� �X
Name: 11A1 i SLI
il,F"IM
Name:
Name:
Inspection Tickets
Name:
/
( �Y
Name:
�(n
Name:
Name:
Name:
Email: S I t I V nnbw " `
Email: r
Email: J
Email
Email
Email: i)0 1tnnU \ IVW�v , .C6
Email:
Email:
Email:
Inspection Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised 10/2016