HomeMy WebLinkAboutAPPLICATION BASEMENT - 17-00487 - 802 S 2275 W - New SFRC I TY OF
REXBURG
OW
Building Safety Department
City of Rexburg
35 North 1st East
Idaho 83440
SINGLE FAMILY RESIDENTIAL BASEMENT FINISH APPLICATION CHECKLIST
The following items should be completed before you submit your building permit application.
*Reasonable accommodations will be made upon re uest.
Submit the Following Documents:
❑ 2 sets of building plans drawn to scale
❑ Floor Plan, Sectional Views, Mechanical Layout, Stair Details, and any details required to illustrate special
construction.
❑ Digital Plans (PDF Format- can be submitted by USB, CD, or Dropbox)
❑ **Copies of any Contractors' State License if not on file already.
Complete the Following Forms:
❑ Permit Policies Acknowledgment signed.
❑ Building Permit Application signed by a registered General Contractor.
❑ Mechanical Permit Application signed by a registered Mechanical Contractor.
❑ Electrical Permit Application signed by a registered Electrical Contractor.
❑ Plumbing Permit Application signed by a registered Plumbing Contractor.
❑ Subcontractor list completed.
❑ Homeowner's Exemption signed, if Homeowner is doing work on their own home.
❑ Affidavit of Legal Interest signed by owner, if applicant is not working directly with owner.
❑ Notifications Distribution List.
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 at http://rexburg.org/t)ages/develol2ment-code.
Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised 10/2016
CITY OF
REXBURG
a
Arnerim's Family Community
BUILDING PERMIT FORM 104
uodzua 10/2016
BUILDING APPLICATION
Single Family Residence Basement Finish
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use �, I
Permit Number: �1 V P Application Fee Paid: 0 $100
1. Proper y Owtier
Name: p ,
Address: 5, City: C tate: 34C
_ Zip Code: 0 LI
Phone: '- Email:t(lt�f�0 �kQ�+•+er�1cM-B e
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?
0 Yes (Skip to #4 and complete the Homeowner's Exemption)
1*01 I am working with the homeowner
2. Appli a t
Name:� Role- (Owner, Tenant, Contractor, etc.)
Address City: State: Z;Q Zip Cod : ��b
Phone: -241 L Emaih(n%�,dLQ
Contact/Rep. Name: i
3. Gener 1 Conti ctor
Name: Registration #: —�[e Exp.:
Address: �i S. City: tate: �_ Zip Code: t'iqb
Phone: 2 - t Email:�Crio - %2 1u • `�
`rl
Contact/Rep. Name:��'p0.V1 Phone:?98! 2,7A-'f//YlEmail: S twos .
General Contractor Authorized Signature: Date: ts2-,7i /
A copy ofyour state registration/license is required to'beAV-CLW If this is the first tirn ou 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 ith the Permit Technician by calling (208) 372-2341.
4. ProjectDescription
Address: NZ S. 27.--6- t -,J . i.
Project Description: V�i1115h �LtS.Q,1'Y�417(V `
• Square Footage being Finished: 1258� sq, ft.
• Check All Included in S�,��c,o�pe�""" of Work:
chanical Workctrical Workpyt mbing Work
Note: Any contracto s involved will need o fill out their respective application.
• Fireplace(s) Being Installed? ❑ Yes
Building Pertaitfeesfor new homes are ch a ed based on squarefootage and the City's estimated valuation. For details on howfees 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 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 nvthful 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 per mit on approval issued erthe ovlsionsofthe2012
International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or appy was based. Per mit void if not
started within 180 days. Permit void if work stops for 180 days.
Applicant's Name (print): Signature: C ate: =L; /
Inspections must be called in be(oreBAM on the day the inspection is requested. Inspection requests II lin after 8 AM wi he scheduled for the next business day.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
CITY OF
REXBURG
America} Family Community
PERMIT POLICIES ACKNOWLEDGMENT
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
The City of Rexburg Building Safety Department is determined to provide excellent customer service. In an effort to help you
understand the City of Rexburg Permit Policies, listed below are several policies which you are required to know prior to
proceeding with your project.
Any construction within the City of Rexburg which requires a permit shall not begin until an approved permit is
obtained. If you do not have a Pink Building Permit signed by the Building Inspector, then you do not have an
approved permit.
o Building without the pink building permit signed by the Building Inspector will result in double fees to be
assessed and the project to be red tagged. If your project is red tagged, halting all construction, only a City
als Official may remove the red tag. If the red tag is removed by anyone but a City Official, citations may be
issued.
No building may be occupied without receiving a signed Certificate of Occupancy.
o If a building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the
occupants may be evicted.
mRlals
Sched ling 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 following
business day.
o If an inspection is not done, the inspector may require any measures to be taken to allow hien to correctly
perform the inspection. (Example: If the electrical rough in inspection is not done and the sheetrock has been
In�t�ais put up, the inspector may require the sheetrock to be removed in order to perform the electrical rough in
inspection.)
Construction on any project can begin ONLY 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 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) 372-2341.
o 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.
Inib Is
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 information is passed on to them or not.
Applicant's Name (print): Kkk(kSignature:
Inspections must be called in before 8 AM on the day the Inspection is requested. Insper
Inspection Hotline -(208)372.2344 www.rexburg.org
Date:S vZ
he next business day.
Revised 10/2016
CITY OF
REXBURG
Am erimt rmnily Cammnnily
SUBCONTRACTOR LIST
Excavation & Earthwork:
Concrete: 1 \3 Lk.\otnA W1,
!
Masonry: 0-'W IV I t, '
Roofing: 2✓LM %2'S� l /
,o/�(�Of aC�
Insulation: `))�l a DaC J✓
Drywall:
Painting:
Floor Coverings: Ce-� Wed—
Plumbing:
Heating: _
Electrical:
L•
Special Construction
(Manufacturer or Supplier)
Roof Trusses:
Floor/Ceiling Joists: �m� We CoC fV06's
Siding/Exterior Trim:
Other:
Building Safety Department
City of Rexburg
35 North 15t East
Rexburg, Idaho 83440
Inspection Hotline -(200)372.2344 www.rexburg.oig Permi[Tecbnician-(200)372.2341 ReOwd 10/2016
e
µE%a Uq
io �G CITY OF
MXBURG
V l\l7 nv
AnwicniF Lip Conunwfry
BUILbING PERMIT FORM 120
ilo ldrartin,
BUILDING APPLICATION
-NewSFR Electrical
TZ, I —
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use
Permit Number. ` O Electrical Fee Paid,
1. Propn r
Opel - w
Name: p�/���
Address: City: tS!!!A!�—St C: ZipCrode:Q3'C' L
Phone; Email �f�°;,"/2 h°✓/j(A'!'t2 C1n'--�
Underldaho Building Code, a homeowner is allowed to do %Volk on their own home.
Are you a homeowner doing work on your own home?
❑ Yes (Skip to #3 and complete the Homeowner's Exemption)
am working with the homeowner
2. E ectrical Contractor
Business:SyNC4 r Gr Jcz r✓It State License#: —Exp.:
Address: Y /�(e City: ►ri ^ State:SQ_ZipCode: P3Vf�3
Phone: —Z9A— Email:
Contact/Rep. Name: Phone: Email;
Electrical Coiifr5ctorduth6rlied Signature: Date:
A copy ofyourstate reglstration/license is require heonfrle. f dsls Nteffrsttfineyou have donework In the CltyofRexburg, pleaseprovlde
u photo copy afyour ficense. Ifyou are unsure i our• license is oufile, please check with the Permit Tedinklmn bycallhlg('200)372-2341.
3. Project Description
Address:T'h-7 nJ• 7 -7Z -4 -St -J. -OR- L Lot #:Block It: Subdivision:
Description t �" `h
❑ New SFR Construction; sq. ft.
• Feesfornew construction are charged bysqum'efootage: Up to 1,500sq.ft. =$130 + $65foreach additional 1,000sq.ft. or
portion thereof.
o Up to 1,500sq.ft. = $130. Up to2,500sq.ft. = $195. Up to3,500sq.ft. = $260. Up to 4,500sq.ft. = $325, etc. (I.e.a
home with 3,675 sq. ft. velli be charged$325)
❑ Spas/fools/Generators:O Yes No
• Note thntspas/poolc/generators are riot Included In squm'efoomge costs Will will be charged $65 per Inspection.
APPIACAN 'CS SIGNATUItIi, CEIV] 'IF] CAT I(IN AND AUTHOOrZATION: Undo penalty of perjury, I herebyeertIfy That I Lave read thin npplicatton and stole tint the IRfmmatlon In ere In
Is correct and I swear that tiny Information wkiclunaybercafter be glve,iby Rol hrjnarhngs beforo the Plaunbig and Zoning Comudsslon or the City Colonel[ for it,. City ofileaburg
shall be trntbfid and correct. I agree to comply wUh alt Clty yogi dIttoils and Slate laws lot itIRg to thesubjecl msaerorlois evident toil Roll herehyaulhorized representatives of 'lip
city to eller upon the abow-lo nunmd propel ty fmInspections purposes. NO'T'E: The building offdal may revoke a perudl un approved Issued under the In ovislous or tiro 2012
IRteru:dlm al Code In arses Rally false statement or misrepresentation of fact In the Application or on the plans on which the perudl or approval was based. Peanit v014 If nor
started within 1 W days. Pei mll void If Wink stops for 100 days.
Applicant's Name (print):
I
Inspections unust be called In before 0 AAl on Molloy the Inspection Is lquesled.
Inspection Iodine - (ZOH) 372.2:144 wwsv.
lho Rost business day.
chordal- (200) 372.2341
1
CITY OF
REXBURG
cY
AmMw3 Tumily Community
BUILDiNG PERMIT FORM 110
upraeso/mss
BUILDING APPLICATION
Afew SFR Mechanical
'i�5irr.en-1�
Building Safety Department
City of Rexburg
35 North 151 East
Rexburg, Idaho 83440
For Office Use
Permit Number: ❑ Mechanical FCC Paid
1. Property ner
Name: 5
Address: __.._1L City: State: Zip Code:
Phone: [ l lQ Email: r rwa
Under Idaho Building Code, a homeowner Is allowed to do workon their own home.
Are you a homeowner doing work on your own home?
❑ Yes (Skip to #3 and complete the Homeowner's Exemption)
N , I am working with the homeowner
2. Mechanical Contractor
Business: mobtarri a State License M 017-5-5-7— Exp.:
Address: MVI E Zqo City: Stat :-AW Zip Code: `� Xcie9`Z
Phone: `+� - Em Il: O
Contact/Rep. Name: l I Phone: S 1224 Emall: 616-6 -0
Mechanical Contractor Authorized Signature;
Acopy ofyourstate reglstration/licenseIsrequiredtobeoi Ile. If this Ist flrstthneyouhavedoneworkintheCityofRexburg,pleaseprovide
a photo copy ofyour license. Ifyou are unsure ifyour license Is an flle, please check with the Perin it Technician by calling (209) 372.2341.
3. Project Description �e
Address: AZZ 6 'IiK� LO - OR- Lot #: ,Block #: -j� / Subdivision: Sw4 p i4z
Description of work: Fjw,<A,, �9r�P�rtGni'
❑ SER Construction: %t /2Q� sq. R.
a Feesfor new construction are charged by squarefootage: Up to 1,500 sq.ft.=$130 e$65for each additional 1,000 sq.ft. or
portion thereof.
o Up to 1,500 sq. ff. =$130. Up to 2,500 sq. f t. =$195. Up to 3,500 sq. ft. =$260. Up to 4,500 sq. Jt. =S.325, etc. (i.e. a
home with 3,675 sq. ft. will be charged $325)
❑ Number of Fireplaces:
I Note thatfireplaces are not Included in squarefootage costs and will be charged $65 per Inspection.
❑ Ilydronic Heating:
a Note that hydronic heating Is not included in squarefootage costs and will be charged and additional $65+($IOx#of
manifolds/zones)
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 1 swear that any Information which may hereafter be given by me In hearings before the Planning and Zeal ng Commission or the City Council for the City of
Rexburg shall be truthful and correct. I agree to comply with all City regulations and Stale laws relating to die subject matter of this appllcatlon 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 ofthe 2012 international Code In cases or 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 within180 days. Permit void lfworkstops for 180 days.
Applicant's Name (print): ' ` kap-- l Signature: Date:
Inspections most be called In before 8 AM on the day the inspection is requested. Inspectionreque called in after AM will be scheduled for the next bus ness day.
Inspection Hotline- (208) 372.2344 www.rexburg.org Permit Technician- (208) 372.2341
yexeuq
° CITY OF
, REXBURG
., ,,, • Amedrds Family Conunntry
BUILDINGPERMITFORM 130
uvemeropme
Building Safety Departinent
City of Rexburg
35 North 15t Bast
Rexburg, Idaho 83440
BUILDING APPLICATION
-A+eptrSFR PhZling
52.n^en
For Office Use. ..
Permit Number; O Plumbing Fee Paid
1. Property net,
Name: �/ p�����
Address; City:. 122)C&
_�C&AEq State: Zip Code:_ Wqn
Phone:2D8''S'L9 ZlI Ln Email_ 0110 n t7jkyk lar n
Under Idaho Building Code, a homeowner is allowed to do wor•lcon their Civil home,
Are you a homeowner doing work on your own home?
❑ Yes (Slip to $3 and complete the Homeowner's Exemption)
I am working with the homeowner
2.PlunlbingC nlractor• pp (n� I�i
Business: OIZAV !'/ti,� 6+^9 �GL State License lt: P1_ 9" _M5_1 zxp.:
Address: 3 76 ° L I+ c e Gtn.'�L rn r� t �Sf;!lte:.1 Zip Code: 8 e%O&
Phone: 'Z°E 5-35 1' Uv Ental]: 7cled" Hm 64 e kld V' cex
Contact/Rep. Name: Acf of ePhone: EDDA]:
PldmbingConEractoi•Autlioi•IzeilSignaEur'e: r Date: f
A copy ofyour state registration/license is required to Ye onfile. If this is first thneyou have done uvork In tine City of Rexburg, please provide
a photo copy ofyour ficensaJfyou are Onsure If your license Is on file, please check with the Permft reclmician by calling (208) 372.2341.
3.ProjectDescription-
r'
Address: SO2 SS• 22�W .. •OR- j Lot s:.Block H: �Subd]vlsion:,�1 I�r1�.2.r�fel
Description of wor]c
t7 New SFR Constructlow sq. ft.
• Poes far new construction are charged by squarefootage: Up to 1,500sq. f . =$130 +$65 for each addiliona11,000sq. ft. or portlaf
thereof.
o Up to 1,500sq.ff.=$130,Upto2,500sq.ft.=$195. Up to3,500sq.ft.=$260. Up to4,500sq.ft.=$325, etc. (i.e.a
home with 3,675 sq. f , velli be charged $325)
❑ Hydronlc (In -floor) Heating: ❑ Yes O No
• Note that hydronfc heating is not Included squarefootage costs andwili be charged$65+($lox 8 of ntonlfoldsl7ones).
APPLICANT'S SIGNAT011 P. CERTIFICATION AND AUTHORIZATION: Under Penally of perjury, i hereby certify that I have read this application and state that the Information herein
Is correct and [swear [lint tiny hrtormatloo which may heren0er he given by ale in hearings before the Plaunlug and'Aoaing Commission or the City Council for the City of Rexburg
shall be 1nnhRl and correct. I agree to comply Will, all city regminl Ions olid Stale Imus relating to the subject matter of this spill kation mill hereby authorized representntives of the
City to orternpon the nhoveanentlmled prnprrty fur lOxpeellnns purpnsrs. NOTE: The building official oily revoke a peralt oil approval issued trader tiro provlxloas of tile '2012
International Code [it cases ofany film statement or misrepresentallon of fact In the application or on the piens on which the perndtor approval was based. Pei mft Vold If lint
slattedwlthlouvidays. poraig void lfworhstops kiln lila days.
Applicant's Name (print); �P , C ` _ _Signature: Date:
Iinspections, Inst be called ht before 0 AM on the lay the lospenloa is requested. Iaspection requests called In after DAM will be scheduled for the next business day.
lmspectlnn llolllno- (200) 372.2344 wWw.YCXhllrg.nl'g Po0n1t Tehniclan- (200) 372.2341