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HomeMy WebLinkAboutAPPLICATION 4 - 18-00495 - 1385 Stone Dr - New SFROF gEXBURc CITY OF Building Safety Department Uq a� .LEXB�URG BUILDING PERMIT FORM130 City of Rexburg ❑pdzted1O,2016 35 North 1St East America's Family Community Rexburg, Idaho 83440 BUILDING APPLICATION For Office Use Permit Number: ❑ Plumbing Fee Paid 1. Property Owner Name: Address: V�Zt.�� City; UT C £'Zs -C� State: Zip Code. Phone: 1 -03) 911. cl /(D� 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. Plumbing Contractor Business: _%� �l't ,n d (" y State License #: 03 w l k Exp.: Address: If City: 3 >< A, f 4i , y State: Z 12 _ Zip Code: i j `l Y � Phone: 'Zv - i' -S y Email: AA6,-le�­Jew,,Mlf)016 Contact/Rep. Name: 61 a/ /c e� w.- �� Phone: 20F,- 3/ 21- Email:v Plumbing Contractor Authorized Signature: AJ, w.. , �7u--JT Date: q A copy ofyour state registration/license is required to be on file. !f this is the first time you have done work in the City of Rexburg, please provide a photo copy ofyour license, lfyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description rr'' ,A Address: (A 3 S �y �r- -OR- Lot #: Block #: _4/Subdivision: '"1 P UfCA-06'vJ 5 Description of work: KdW 1,= 11] -New SFR Construction: sq. ft. Fees for additions are charged by square 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. $Y95 Up to 3, 500 sq. ft. $260 Up to 4500 sq. ft $32S Add $65 per additional thousand sq. ft Hydronic (In -floor) Heating: ❑ Yes [E>o • Note that hydronic heating is not included in square footage costs and will be charged $65 + ($10 x # n ­­­ o alurvfti Unc, Unrci IrK.A i IUN ANL)AUTHOKIZA'I'ION: 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 , Signature: Date: j 2W r/2 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 Building Safety Department gEXBUR CITY o F City of Rexburg 444'A 1�URG BUILDING PERMIT FORM 120 35 North 1St East s Updated 10/2016 CIV Americas Family Community Rexburg, Idaho 83440 BUILDING APPLICATION New SFR Electrical For Office Use ❑ Electrical Fee Paid Permit Number: 1. Property Owner S4( 75b Name: i ity: 5 Sta e: Zip Code: _ Phonel "C��`lU 1 �� Email: 2 'i t''„evr �, Goin 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_ !! n " Business: // lac/_1-1c State License #: �� 5_ Exp.: Address: 2" C' City: �fIIG'�1 State:_ Zip Code: Phone: $ % . SGi Email: IGiC; ctr ' Contact/Rep. Name: " k n' Phone: ail: Electrical Contractor Authorized Signature: Date: A copy ofyour state registration/license is required to b on file. 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 D sc ' tin Ja� Address: �-OR- Lot #: I Block #: _�_ Subdivision: Description of work: �e 4-- L� ❑ New SFR Construction: sq. ft. • Fees for additions are charged by square 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 I ❑ Spas/Pools/Generators: ElYes WNo I • Note that spas/pools/generators are not included in square footage costs and will be charged $65 per inspection. 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 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): Signature: 4 ©�%�`""� �� 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 wvvw.rexburg.org Permit Technician - (208) 372.2341 O44EXBUA6 �7 CITY o f Building Safety Department REXBURG BUILDING PERMIT FORM 110 City of Rexburg ®0 bpd—d 10/201' 35 North 15t East '•<,, E ,o' America's Family Community Rexburg, Idaho 83440 BUILDING APPLICATION New SFR Mechanical For Office Use Permit Number: ❑ Mechanical Fee Paid 1. Property Owner Name: 12— 1A-0 Addres : a3�W_rl nZcw�. Fc 1 �j Phon $)3�`+b_C 6q City: e° e- State: �i Zip Code: qI Email: X(f. CC,, cao-­k, Under Idaho Building Code, a homeowner is allowed to do work on their own home. J Are you a homeowner doing work on your own home? ❑0Yes (Skip to #3 and complete the Homeowner's Exemption) LI No, I am working with the homeowner 2. Mechanical Contractor Business: State Li ense #: Address:' � Phone: - -1 �' �0(� Email- Contact/Rep. Name:C r-- Phone:23 /h! Mechanical Contractor Authorized Signature: 4- : A copy ofyour state registration/license is required to be on file. If this is the a photo copy of your license. Ifyou are unsure ifyour license is on file, please 3. Project Des ri tion Address: 13 -OR- Description of work: 1�� Sti, �z�w�' CfSFR Construction: sq. ft. Exp.: 130I� —State: i Zip Code:q 3 VJ f r- -Email: — _Email: '- Dater 2� first timeyou have done work in the City of Rexburg, please provide check with the Permit Technician by calling (208)372-2341. Lot #: 14 Block #: q Subdivision: KA E? _s OW k"`el- Fees for additions are charged by square 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. o ❑in $130 ❑ Free-standing $65 ❑ Hydronic Heating: • Note that hydronic heating is not included in square footage costs and will be charged and additional $65 + ($10 x # of manifolds/zones) ---- --- ------------ - ----� r -.....r --Y, i --y ­ Lily inai i nave read tris 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. 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 void if not started within 180 days. Permit vodt1rWW5—rRTMprfr,s, Applicant's Name (print): Signature: Date:_0 Inspections must be called in be/re 8 AM on the day the inspection is requested. Inspection re uests e m after 8 AM will be scheduled for the next business day. Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341