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Home My WebLink AboutAPPLICATIONS - 19-00106 - 2204 Summerfield Lane - New SFRO1 TY O P REXBURG Aniericr2's Family Conommity BUILDING PERMIT FORM �3 Q npaolra 10/2016 BUILDING APPLICATION New SFR Plumbing Building Safety Department City of Rexburg 35 North 181, East Rexburg, Idaho 83440 For Office.Use Permit.Number: b Plumbing Pee Paid 1, Property Owner Name: Address: City: State: Zip Code: Phone: 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 woridng with the homeowner 2. Plumbing Contractor / l Business: P-1 State License It: �"C" /%5 /x p.: Address: got a".'t y.✓ A. n •-z C -t /State: :179 Zip Code: f3 �'V66 Phone: 766 5-35 % oei Email:. �cfc's�Yo n a C� Y��,c,, eco•, Contact/Rep. Name: act Ir- 0-, be Phone: H M Ill 1: / Plumbing Conti'actorAutlioi'iz6d Signature: / C� Date:_-31�% -f A copy ofyour state re,9Lstr•atlon/license is required to be on file. If this Iso first timeyou have done work in the City of nexburg, please provlde a photo copy ofyour license, Jfyou are unsure ifyonr license is on file, please check with the Permit Technician by calling (208) 372.2341. 3. Project Description Address: OR- Lot #: _, Block #: Subdivision: Description of work: ❑ New SFR Construction: sq. ft. • Dees far new construction are charged by square footage: Up to 1,500sq, ft. = $130 + $65 for each atlditional1,000 sq, ft. or portion thereof. o Up to 1,500 sq. ft =$130, Up to 2,500 sq. ft. =$195. Up to 3,500 sq. f. =$260. Up to 4,500 sq. fr =$325, etc, (i.e. a home with 3,675 sq. f . will be charged $325) 13 Hydronic (In -Floor) Heating: ❑ Yes ❑ No • Note that hydronic heating is not included in square footage costs and will be charged $6.5 + ($10 x 11 of manifolds/zones). APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: thiderpeimiyorplojory, I herebycertify tbat I have read thisapplIcitIonand state that the Information herein is correct mud I swear thntnoy information which may hereafter be given by me In hearings beforo the. Planning and'Lolbig Commission 01' 1110 City Couticil for the City of Rexburg shall he Inuhful and correct. I agree torn imply with all City regulattoas old State lows reh iting to lite suited matter orthls oppiicatiou and hereby nuthorized ropiesenmttves of the City to enter upon the above-menHnned prop0rty for Inspati0ns purpescs. NOTE: The building official may revuk0 a permit o1 approval issued under th0 provlstous of t11o'l01'Z International Code In cases orally false statement or misrepresentatioi of fact In the application or on the phos on which the permit or approval was based. Permit void If not started within iot days. Permit void If wnrlt stops for Ino days. Applicant's Name (print): __ —Signature: Date: Inspections inust bo called hi heforo fl AM on the day the InspecNuii is requested. Inspection roquesk called In after n AM will ho scheduled for the next buslaoss day. Inspectioi i lotllno - (200) 372.7.344 wwwavitburg,nrg Po•mil Tvchilclao - (2011) 372.2341 Cf TY OF REXBURG •� c BUILDING PERMIT FORM Updated 1eJ2J16 110 Building Safety Department City of Rexburg 35 North 1St East Arncrxns rnigrvmrmtmry Rexburg, Idaho 83440 BUILDING APPLICATION New SFR Mechanical For Office Use Permit Number: ❑ Mechanical Fee Paid 1.. Property Owner Name: Address: City: State: Zip Code: Phone: 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) 13 No,1 am working with the homeowner 2. Mechanical Contractor r,{ Business: as LIP4J+ State License #: 017-5-5-2- Exp.: �;->f rs _ Address: - zqc,City: 4 State:_ Zip Code: Phone: 't> .744 <- 2 ( E41: 0 � z� j f e.. Contact/Rep. Name:, 4l, 1 Phone: -11W- 10-1,1 Email: _.. Mechanical Contractor Authorized Signature: '`--'-- `''1 —Date: -.7- A copy of your state registration/license is required to be on file. If this is th first thne you have done work in the City ofRexburg, please provide a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with tine Aennit Technician by calling (208) 372-2341. 3. Project Description Address: -OR- Lot #: ` Block #: _ Subdivision: Description of work: 13 SFR Construction: sq. ft. • Fees for new construction are charged by square footage: Up to 1,500 sq. ft. = $130 + $65for each additional 1,000 sq. ft. or portion thereof. o Up to 1,500 sq. ft. = $130. Up to 2,500 sq. ft. = $195. Up to 3,500 sq. ft. = $260. Up to 4,500 sq. ft. = $325, etc. (i.e. a home with 3,675 sq. ft. will be charged $325) D Number of Fireplaces: • Note that fireplaces are not included in square footage costs and will be charged $65 per inspection. O Hydronic Heating: • Note that hydronic heating is not included in square footage costs and will he charged and additional $65 + ($10 x # of manifolds/zones) APPLICANT'S SIGNATURE,CERTIVICATIONAND 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 rue In hearings before the Planning and Zoning Commission or the City Council for the City or Rexburg shall lie 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 Ute 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 orapprovai was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Applicant's Name (print): Signature: 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 www.t*exburg.org Permit Technician — (208) 372.2341 /r� 4pCXdpge,O CITY OF Building Safety Department "Q o, r jMG BUILDING PERMIT FORM 120 City of Rexburg i� UpdeUd70/1016 35 North 1St East '•,,, .> Americal Fioniiy Ununtrnity Rexburg, Idaho 83440 BUILDING APPLICATION New SFR Electrical For Office Use Permit Number: D Electrical Fee Paid 1. Property Owner Name: Address: City: State: Zip Code: Phone: 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? D Yes (Skip to #3 and complete the Homeowner's Exemption) D No, I am working with the homeowner 2. Electrical Contractor 1J Business: i7kt'Z 1145. State License #: a�84'fA Exp Address: � �X 1/60 City: r�'T i /`r' � State.,. Zip Code: Is 3ys�3 Phone:irWk — �'� r� Email: c. i .r. � ��•t.t,%. Cej t✓� Contact/Rep. Name: a Phone: Email; Electrical Contractor Authorized Signature; Date: – A copy ofyour state registration/license is require be ort file. 1771& is the first tinteyoii have done work in the City of Rexburg, please provide u photo copy nfyour license, ljyou are unsure if, our license is on file, please check ivith the Perritt Technician by calling (208) 372-2341. 3. Project Description Address: -OR- Lot #: — Block #: _ Subdivision: Description of work: 0 New SFR Construction: sq. ft. • Feesfor-uew construction are charged hysquare footage: Up to 1,500 sq. JY. =$130 +$65 for each additional 1,000 sq. ft. or portion thereof. o Up to 1,500 sq. fi =$130. Up to 2,500 sq. ft. = $195. Up to 3,500 sq. ft. = $260. Up to 4,500 sq. ft•. = $325, etc. (Le. a home with .7,675 sq. ft. will be charged $325) 0 Spas/Pools/Generators: 0 Yes 0 No • Note thatspas/pnnLr/generators are not included in square footage costs and ivill be charged $65 per Inspection. APPLICAN'r S SIG NA'I'URV, CV.1ITIFICA'I•ION AND AUTHORIZATION: Under penally of perjury, I hereby certify that I have read this application and state that the Information bereln is cut rect and 1 swear that any Information which may hereafter be given by me in hearings before the PlannIng aud Zoning Commission or the City coilnell for the City of Rexburg shall be truthful and correct, i agree to comply with nil City regulations rind State laws relating to the subject rnatterorthis application and hereby authorized representatives of the City to enter upon the abovrowotioned propel ty for Inspections pm poses. NOTr; The building official may revolve a permit on approv;ll issued under the provisions of the 2012 International Code lit cases ofany false statement at, misrepresentation of fact In the application or oil the plans on which lite permit or approval was based. 1'ennit void If not started within 100 days, Permtt void If work slops for 100 days. Applicant's Name (print): Signature: Date: Inspections must be called in before 8 AM on the day the inspection Is requested. inspection requests called ht after CAM will be scheduled for the next business day. Inspection Hotline- (208) 37.1..2344 www.rexiturg.org Permit Technician - (208) 372.2341