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Home My WebLink AboutAPPLICATION 2 - 08-00033 - Johnson Precast Shop,I Building Safety Department o sexaeR�, C IT Y OF City of Rexburg '=o n r V nT mG 1�.1� 1� lJ 1� �.— � -- 19 E Main jonellh@rexburg.org Phone: 208.359.3020 x326 AmencA Famfly Commuulry Rexburg, ID 83440 wwnw.rexburg.org Fox: 208.359.3024 OWNER'SNAME Johnson Pr°casE.GLC Permit #08 00033 PROPERTY ADDRESS 551 E M o gd 4e Azo( SUBDIVISION A)/14 Johnson Proust Shop PHASE LOT BLOCK 551 E Moody Rd RequiredN ELECTRICAL Electrical Contractor's Name r Netil L f Business Nam 4 Address 'V'0- So ff�y�( Ciry State C� Zip Cell Phone Business Phone Fax ( ) psi <:9//9 Email Electrical Estimate (cost of wiring & labor) $ (COMMERCIAL/MULTI-FAMILY ONLY) TYPES OFINSTALLATION (New Residential includes everything contained nithin the residential structure and attached garage at the same time) i Number of meters being installed Up to 200 amp Service* 201 to 400 amp Service* Over 400 amp Service* Existing Residential (# of Branch Circuits) Temporary Construction Service, 200 amp or less, one location (for a period not to exceed 1 year) Spa, Hot Tub, Swimming Pool Electric Central Systems Heating and/or Cooling (when not part of a new residential construction permit and no additional wiring) Modular, Manufactured or Mobile Home Other Installations: Wiring not specifically covered by any of Cost of Wiring & Labor: $ Pumps (Domestic Water, Irrigation, Sewage) Requested Inspections (of existing wiring) Temporary Amusement/Industry *Includes maximum of 3 inspections. Additional inspections charged at requested inspection C—(`/ 3`/ Sign of Licensed Contractor License number The City ofRexbarg'.r permit fee scbedule is the same as re. Date The State of Idabo JAN 15 2008 IL REXBIJRO 'I P. 1 Me, ory TX Result Report ( Jan, 23. 200, 111:45AM) t 1) 2) Date/Time: Jan.23. 2008 11:44AM File Page No, Mode Destination pg (s) Result Not Sent ---------------------------------------------------------------------------------------------------- 5684 Memory TX Rocky Mtn Power P. 1 OK -------------------------------------------------------------------------- Reason for error E.1) Hang up or line fail E.2) Busy E.3) No answer E.4) No facsimile connection E.5) Exceeded man. E—mail size . N'�Y .� a•✓Ln9� Building Safety Department w ,, yp �W `MMbnr9,.... .., REXBURG 19EMin �ICM2tW.d0 Wba'mB359l�,)a} 3nWaFn�lawq xe+umomuo nw a.w Ee.:oal�_mu OwNAA•SN JOGS Qieusf. ccc.. Permit #08 00033 PAOPRATYADDR 6S/ E Meed. ed SUBDI ION "M Johnson Precast Shop P "5E W RLOCrI_ 551 E Moody Rd Requiredlif ELECTRICAL Bvctdd Conuncmte Name /]_y [, �yel .. Ihssioens Nava Addrcaa •a/Yl Sa � F�� Cily��Sam i d Z'p k 3vNo fxnPbm,e( )�90 iYzs a ., pna�e( ) z�56-370 Fu( ) �S9 n99i4' Em.0 BAeaical Hetimece (maofa dognvb9p6 (COMMHRC /MULTI-F"MY ONLY) ]'YFIiS OFINSlALIATlO Fxae.:a ee�tw�e,:ryw a.a,over.rsv,a.R,rm,e.r,o..�.,ve,..meaea.ne.rms.we a«/ i Nmbaofinereo be'utgimmlled �Upm200 amp Service• _2%m100amp Serve* Ova CO wp Sante• E a%Rvv mtbl(N oF&mch amw%) Tavpmq CaoatmtIm Swim 200 mp m lee -one lomum (f apeed not to ae lyra) Spa, Hot Tub, 5wimmiog Pool Eleado Cmtol Syetam Headng W. C .hg a.orom�e®¢il emvmuvmpeuvir W maadieoodvmgt Modulo. Mmugrcmred m MobOe Hme Otiu loamllatiom: widngnatepxi( llymuadhyay ofVE Mn Cwtofwidag&La--. p—..^iD �wmp, p— W--. sew,ge) JAN 152114 Requaredl pavan(o(meuvg wlung) T mpm"mm� m nt/,naaa, REXBURG l •9e.tde m ivm MllaryaJens. M6damlmapntiama6agdacgmo-db.pntlm I®, ofliygi Wle[nv Ii®,evmLa D[k 'Ife Y ,ibkvae.ws MSw IbM ar CITY OF REXBURG 0800033 BUILDING PERMIT APPLICATION Ple: Johnson Precast Shop ri! 19 E MAIN, REXBURG, ID. 83440 P 208-359-3020X326 551 E Moody Rd PARCEL NUMBER: i) � (We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# is oases on me mtormanon - must oe OWNL•XNAMH, �ldhnsnrl fercusf LLC_ CONTACTPHONE# PROPERTY ADDRESS: 6S / E. /'✓I o d u K o a d 17• e v b "`� T'7 'F3N e! a tr—. PHONE #: Home ( ) N /ii Work (Z&5b y97-7 Cell (2cl 351 q5o / OWNER MAILING ADDRESS:. D Roy 406 CITY: 2eqlqt,ro STATE:7a ZIP: F -3W1 EMAIL76pi,Itee69 hC FAX ?t)T-651/ ooZo .,,,.,t APPLICAN : (If other than owner) (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS CITY: STATE: ZIP EMAIL FAX PHONE #: Home ( ) Work ( ) Cell ( ) CONTRACTOR LSP r14,0 t' MAILING ADDRESS: M- CITY A) STATE P,/ LIPS PHONE: Cell# Work# /1%/{i Fax# wz/f EMAIL ii% IDAHO REGISTRATION # & EXP. DATE wji How many buildings are located on this property? Did you recently purchase this property. No Yes (If yes give owner's name) Is this a lot split? ® YES (Please bring copy of new legal description of prope JAN j 5 2008 PROPOSED USE: Llgh i- T recry ty 7-,0 - (.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Et .) U IT/ OF R EXB U R G 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 near 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 build in official may revoke a permit on approval issued under the provisions of the 2003 International Code in cases of any false statement or misrepresentation of fact in the app' on or on the pla which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 18o days. Signature of Owner/Applilant DATE Do you prefer to be contacted by fax em ' r hone Circle One WARNING — BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE! Plan fees are non-refundable and are paid in full at the time of application beginning hmmmy_1. Avg, City of Rexburg's Acceptance of the plan review fee does not constitute plan approval **Building Permit Fees are due at time of application** "Building Permits are void if your check does not clear" Building Safety Department City of Rexburg 19 E. Main ionellh@rexburg.org Phone: 208.359.3020 ext 326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 Affidavit of Legal Interest State of Idaho County of Madison n n Name Address City State of pEXBUgC U � C IT Y OF MXBURG Amerirds family Cammunf y Being first duly sworn upon oath, depose and say: (If Applicant is also Owner of Record, skip to B) A. That I am the record own e of the pxoperty described on the attached, and I errant my permission to: Jnhnsor\ j t s , Lt.0 $5/ E.I'Yl cooC y Qd • lCev %rvtiy TA 83�1� 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 herin or as to the ownership of the property which is the subject of the application. Dated this 8 Subscribed and sworn to before me the day and year first above written. RGO NotafftUllecof Idaho zz ly C� r: Residing at: a IC ak My commission expires: 2 201 �', , Plegse complete the ejuLhre Application! the question does not apply fill in NA for non applicable NAME Joh n son rC [ lis f u 6 PROPERTYADDRESS 55/ E. rncocU Permit# SUBDIVISION Nl/k Dwelling Units: Parcel Acres: 3 SETBACK PN — ( t FRONT Pv �t P SIDE SIDE t� BACK 3 5 Remodefing Your Building/Home (need Estimate) $ IVIP SURFACE SQUARE FOOTAGE., (Shall include the exterior wall measurements of the building) First Floor Area Second floor/loft area Third floor/loft area Shed or Barn Water Meter Quantity: RequiredX PLUMBING Plumbing Contractor's Name: Contact Phone: ( Clothes Was g 1 Dishwasher Floor Drain Garbage Disposal Hot Tub/Spa Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate Unfinished Basement are,, Finished basement area_ Garage area Carport/Deck (30" above (Commercial Only) Water Meter Size: Sprinklers Tub/Showers Toilet/Urinal Water Heater Water Softener Required! Signature of Licensed Contractor License number Date The City of Rexburg i permit fee schedule is the .came as required by the State ofldabo H Please complete the ent,...) Application! If the question doee -at apply fill in NA for non applicable n / NAME J)hylsok4 PreL(� S!, LLG PROPERTY ADDRESS C 5) Eo maG� Permit# SUBDIVISION el A RequiredLY MECHANICAL Mechanical Contractor's Name: N 0 ni e Business Name: N//T q/ Address N �fT/ City /, /�/State�Zip Contact Phone: ( ) /V /p Business Phone: ( ) ZY& Email �% �� Fax �f Mechanical Estimate $ elk (Commercial/Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) Furnace Furnace/Air Conditioner Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space Heater Decorative gas-fired appliance Incinerator System Boiler Pool Heater Fuel Gas Pipe Outlets including stubbed in or future outlets Inlet Pressure (Meter Supply) PSI Exhaust or Vent Ducts Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans Required! Signaturef Licensed Contractor License number Date The City of Rexburg i permit fee sebedule it the same as required by the State of Idabo Building Safety Department City of Rexburg 19 E. Main jonellh@rexburg.org Phone: 208.359.3020 Rexburg, ID 83440 www.rexburg.org Fox: 208.359.3024 APPLICATION: "CONSTRUCTION PERMIT" C I TY OF REXBURG -- AmericO Family Community CONSTRUCTION PERMIT #: PERMIT APPROVED: YES/ NO $50.00 FEE PAID: YES/NO APPROVED BY: -APPLICANT INFORMATION - Business Name: n ilre c o s L. Office Address: 551 E . ✓nved_q yp 83gq City State Zip Office Phone Number: ( Zoff I (P57& _1� 977 Contractor Performing the Work:A>� �YJwr (- Contact Person: N 4 Cell Phone # (_) )U.l%i' -LOCATION OF WORK TO BE DONE: Street Address Where Work Will Be Done: 55/ E_ filoadqad- Business Name Where Work Will Be Done: Joh ii srw Dates For Work To Be Done:1 �ZT US - To 111/7,�o Sl Contact Person: e_vt , k h nsP1-- Phone Number: (ZW 35/-150 / Cell # ( L) 35/-450 / PLEASE CHECK THE TYPE OF PERMITS) YOU ARE APPLYING FOR: ❑ AUTOMATIC FIRE -EXTINGUISHING SYSTEMS ❑ COMPRESSED GASES ❑ FIRE ALARM AND DETECTION SYSTEMS AND RELATED EQUIPMENT ❑ FIRE PUMPS AND RELATED EQUIPMENT ❑ FLAMMABLE AND COMMBUSTIBLE LIQUIDS ❑ HAZARDOUS MATERIALS ❑ INDUSTRIAL OVENS ❑ LP -GAS ❑ PRIVATE FIRE HYDRANTS ❑ SPRAYING OR DIPPING ❑ STANDPIPE SYSTEMS ❑ TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES 44 /-�vz Applicant's 51gnature Date ........................................................................................... SUBCONTRACTOR LIST Roofing: Jo h h 6,m Pr e C 4 5 /' Insulation: jb h kq 50Y— Pr PCS 5— Floor Heating:// /V 0L-" Electrical: tt 15 h / !Ma v j / / f - I" e t'! Special Construction (Manufacturer or Supplier) Floor/Ceiling Siding/Exterior EXEMPTIU'NS FROM STATE RE(ASTRATION 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 send a copy of your state registration or fill out this form showing your exemption and send it with your license renewal or your next permit application. (This list is a summarization of Idaho Code Title 54 Chapter 5205, for full definitions of these exemptions please see the State's website at www.ibol.idaho.gov/cont htm) ❑ Currently State licensed pursuant to Title 54 Idaho Code, Chapters: 3 Architects, 10 Electrical Contractors/Journeyman, 12 Engineers/Surveyors, 19 Public Works Contractors (exempt from fee only registration required), 26 Plumbing/Plumbers, 45 Public Works Construction Management Licensing Act (exempt from fee only registration required), or 50 Installation of heating, ventilation and air conditioning systems ❑ Employee or volunteer of a licensed contractor or part of an educational curriculum or nonprofit charitable activity with no wages or salary ❑ Employee of a US Government agency (State, City, County, or other municipality) ❑ Public Utility doing construction, maintenance, or development to its own business ❑ Involved with gas, oil or mineral operations ❑ Supplier doing no installation or fabricating ❑ Contracting a project or projects with a total cost less than $2000 ❑ Operation of a farm or ranch or construction of agriculture buildings exempt from Idaho Building Code ❑ Any type of water district operations ❑ Work in rural districts for fire prevention purposes Owner who performs work on own property or contracts with a registered contractor to do work as long as the property is not for resale within 12 months Owner or lessee of commercial property performing maintenance, repair, alteration or construction on that property ❑ Real estate licensee/property manager acting within Idaho Code ❑ Engaging in the logging industry ❑ Renter working on the property where they live with the property owners approval Cl Construction of a building used for industrial chemical processing per Idaho Code ❑ Construction of a modular building (defined by Idaho Code) to be moved out of state I hereby^Xtify that the,#ove information is true and correct to the best of my knowledge. Signature M �JJh n sari Print Name .7 - Date