Loading...
HomeMy WebLinkAboutAPPLICATION - 18-00558 - 1376 Stone Dr - New SFR04 RExe URC o� b CITY o F Building Safety Department ' REX.BURG BUILDING PERMIT FORM100 City of Rexburg Updated 10/2016 '' .•' America's Family community 35 North 1St East N[D Rexburg, Idaho 83440 BUILDING PERMIT APPLICATION New Single Family Residence For Office Use Permit Number: __N - (> > Zoning: Application Fee Paid: ❑ $500 1. Property Owner Name: Address:CIty. Phone: l�i�� ��`(- L�-lo�iL v_�►i�+��--'�-'�► State: l�� Zip Code: Emai: Under Idaho Building Code, a homeowner is allowed to do work onitheiir own hom �oW1�se-(��� • c c �� Are you a homeowner doing work on your own home? ❑ Yes (Skip to #4 and complete the Homeowner's Exemption) :J�No, I am working with the homeowner 2. Applicant Name: Address: Phone: Contact/Rep. Name: Role: (Owner, Tenant, Contractor, etc.) City: State: Zip Code: Email: 3. General C ntraetor Name: XPV4tJ i� �� Re istration #: �T ��{ (� ZS� Ex l Z2,�/7 Address: r p.:City: J(� State:ti $sziy p Phone: t 3 Fi �c } `i�F li Zip Code: Contact/Rep. Name: ? Email: �•a�rn �� G h(� L� c �\ e- l"hon : Com` Ztii --7� S mail: General Contractor Authorized Signature: /J A copy ofyour state registration/license is required to be on file. if this s 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 Address: �' , 7 i© -V Q -OR- Project Description: ✓ • Square Feet: Building Total: s ft. q• o Main Floor: sq, ft. o Additional Floors: sq. ft. o Basement: Lot # 3 _ Block #: 2. Subdivision: • # of Water Meters: Water Meter Size: • Fireplace(s) Being Installed? ❑ Yes ❑ No • Hydronic Heating Being Installed? ❑ Yes ❑ No Finished sq. ft. Unfinished sq, ft, Building Permitfees for new homes are charged based on square o Garage sq.ft. footage and the City's estimated valuation. For details on how fees are calculated, contact the Building Department. There will also be • Estimated Total Cost: $ 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 m cases of any f se 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 'll days. Applicant's Name (print)ALP Signature: F g Date: ( A,11 y Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after AM will be scheduled for the next business day. Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341