HomeMy WebLinkAboutAPPLICATION - 19-00142 - 576 E 5th S - New SFRCITY OF
L-"�REXBURG
AmericasFirnril}'r�Comn zurity.
Building Safety Department
City of Rexburg
35 North 1St East
SINGLE FAMILY RESIDENTIAL APPLICATION CHECKLIST
Idaho 83440
The following items should be completed before you submit your building permit application.
*Reasonable accommodations will be made upon request.
Submit the Following Documents:
d 2 sets of site la
m
I, ns (see Site Plan Checklist)
2 sets of building plans drawn to scale (see box to right)
❑ 'Foundation Plan,'�(ilO7JoistLayout, FloorPlan,�'RoofLayout Truss Details, Sectional Views, Front, Back, and Side
vElevations,'kechanical Layout, Stair Details, and any details required to illustrate special construction.
Note: All Plans and Construction must conform to IRC 2012 standards.
Structural Calculations (see box to right) - stamped by a licensed Engineer
Energy Compliance Report: As per the 2012 IECC, a RES h c�isrequired
(available online at www.energycodesenv)
Qf Digital Plans (PDF Format - can be submitted by USB, CD, or Dropbox)
**Copiesof any Contractors' State License if not on file already.
Nil'. ,_ 0,kiixe.;
Complete the Following Forms:
Ei Site Plan Checklist completed.
d` Permit Policies Acknowledgment signed.
t� Property Line form signed by builder.
[Y Building Permit Application signed by a registered General Contractor.
19/ 'Mechanical Permit Application signed by a registered Mechanical Contractor.
13' Electrical Permit Application signed by a registered Electrical Contractor.
03"' Plumbing Permit Application signed by a registered Plumbing Contractor.
D"' Subcontractor list completed.
Seismic Design Category - D
Ground Snow - 50 lbs. per sq. fL
Roof Snow Load - 35 lbs. per sq. ft.
Wind Load - 90 MPH
Frost Depth - 36"
E( Homeowner's Exemption signed, if Homeowner is doing work on their own home.
,M0 Affidavit of Legal Interest signed by owner, if applicant is not working directly with owner.
e Notifications Distribution List
Note: Please check the Rexburg Development Code for any requirements such as property setbacks,
design board approval, etc.
This information is available at httn: //rexburg orgJpages/development code.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
Revised 2/2017
�' CITY OF
yn -- - - - Building Safety Department
RExBURG City of Rexburg
AmerictAFat?jiryco,n„tu,titr 35 North 11t East
Rexburg, Idaho 83440
SITE PLAN CHECKLIST
1 1 Site plan must be drawn to scale, be legible and also be submitted electronically if possible.
2. Adjoining streets labeled.
C71 3. Right-of-way location and width, curb to curb widths and sidewalk location.
E� 4. Building location, sq footage and dimensions, with distance to property lines and distances
between buildings.
S. Show existing and proposed easements.
13 6. Existing utilities (waterlines, sanitary sewer lines, manholes, storm drains).
IR 7. Proposed utilities including tie in location to existing services and new easements.
%-1AD 8. Proposed storm drain and sanitary sewer elevations (for pipe inverts at manholes and catch basins).
tJ/kO 9. Storm drainage plan for parking lot and roof areas, with calculations.
t i f po 10. Fire hydrants and fire suppression lines (including tie to City lines).
0 Sprinkled 0 Not Sprinkled
ll/b 11. Indicate Fire apparatus access.
r1/91 12. Parking (including parking lot, drainage arrows, dimension of lot, distance between rows, and total
numbers).
1� 13. Landscaping (type and total area, including dimensions).
641 IN 14. Trash facilities.
d 15. North Arrow Included
E14 16. Proposed street improvements (curb, gutter, sidewalk, pavement, etc.)
Ei 17. Legal description of proposed building site included.
N� 18. Percent of lot covered by building or paving calculated.
a14- 19. Show 10% snow storage area.
Pf' 20. Distance of entrances from street corner indicated.
�f�& 21. Current VicinityMa 8 ,
p. ( 1/2 x 11") at 1" = 300 scale, showing location of the property.
k� 22. Lighting Plan
SITE PLANS MUST BE COMPLETE AND SUBMITTED FOR REVIEW BEFORE THE PROJECT WILL BE PLACED ON
THE PLANNING & ZONING AGENDA.
Inspection Hotline - (208) 372.2344
www.rexburg.org Permit Technician - (208) 372.2341
Revised 10/2016
`,�
4 i� CITY OF
REXBURG
America's Fandly Conununiip
PERMIT POLICIES ACKNOWLEDGMENT
Building Safety Department
City of Rexburg
3S North 1st East
Rexburg, Idaho 83440
The City of Rexburg Building Safety Department Is determined to rovide excellent customer service. In an effort to help
understand the City of Rexburg Permit Policies, listed below are several policies which you are required to know prior to u
proceeding with your project I
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
a proved ermit.
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 Official may remove the red
Initials tag. If the red tag is removed by anyone but a City Official, citations may be issued.
No buildin 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.
Initials
A Certificate of Occupancy will not be issued without digital copies of the As -Built Plans.
It is the Applicant's responsibility to turn in digital copies of the As -Built Plans when the project is completed. No
212' &InitiCertificate of Occupancy will be issued without these plans.
Scheduling 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
da .
o Required inspections can be found on the inspection sequence page in this packet If an inspection is not done, the
inspector may require any measures to be taken to allow him to correctly perform the inspection. (Example: If the
electrical rough in inspection is not done and the sheetrock has been put up, the inspector may require the sheetrock to
InRi be removed in order to perform the electrical rough in inspection.)
Construction on any project can begin O1VLy when you have received a Pink Building Permit from the Building
Department. Occupancy of any structure can begin Q NU when you have received an official Certificate of Occupancy
from the Building Department.
o A verbal approval does not constitute approval of these documents. Ultimately if you do not have a Building Permit or
Certificate of Occupancy, the above policies will be enforced. These documents must be signed by the appropriate
Initials authorities from the City of Rexburg. Any approvals can be verified by calling (208) 372-2341.
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.
IA— �1 o The above policies will be enforced to all, regardless if this information is passed on to them or not
Applicant's Name (print): -yk- K
Signature: Date: 3 1 �J 2clt
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
Revised 2/2017
�sex at•,q
-C' Ty OF Building Safety Department
REY.-BuRG City
n„ of Rexburg
—
Anierirn'sFamilyCanmunlg' 35 North 1St East
Rexburg, Idaho 83440
PROPERTY LINES
Each site plan that is submitted to the City of Rexburg for the Building Permit process requires that property lines
are shown accurately. It is the Developer's responsibility to correctly identify on the site plan the location of these
lines in reference to the public right-of-way, other adjoining property lines, the street, other structures and all
utility lines. The Developer should find property pins that are still available at the lot in question. If these pins do
not exist or have become unrecognizable then a new survey should be performed.
Accurate property line information is a must for a timely review. In addition to finding existing property pins,
legal descriptions should be checked. The best way to identify property line location is with a land survey. The
City of Rexburg has aerial photos and a parcel line layer that can be checked, but they are only a tool and are not
guaranteed for accuracy. This information is available at madison.rexburg_org. If you want to request a copy of
your lot information, contact the Community Development Department.
I have read and understand the above requirements.
Signature
Printed Name
3 is �oi�
Date
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
Revised 10/2016
ourxat•,gr,
C I T Y O F Building Safety Department
c REXBURG
BUILDING PERMIT FORM 100 City of Rexburg
11.1' ----- - Updated 30/Z016
Americas Family Connnmtity 5 North 1st East
Rexburg, Idaho 83440
BUILDING PERMIT APPLICATION
New Single Family Residence
Permit Number:
Zoning:
Application Fee Paid: ❑ $500
i. J'rol)(2rty Owner
Name:
Address: CRnl�icn.! lr Nj Cc'r 2 6i.1�4 City: 12x6u rz�,
Phone: l top) Ott •-octS % State:. = Zip Code: ' `fyC)
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?
1KYes (Skip to -,:J, and complete the Homeowner's Exemption)
❑ No, I am working with the homeowner
2. ,� pli. gilt
Name:
Address:
Phone:
Contact/Rep. Name:
Name:
Address:
Phone:
Contact/Rep. Name:
Role: (Owner, Tenant, Contractor, etc.)
City:
Email:
Registration #:
City:
Email:
State: ______ Zip Code:
Exp.:
State: Zip Code:
Phone: Email:
General Contractor Authorized Signature:
A copy ofyour state registration/license is required to be on file. If this is the first time you have done work in the City of Rexburg, please Prov;
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: 51G T S•i-kS•o,,.ry} -OR-
Project Description:� To. v3,rzro
• Square Feet: Building Total: k-7 -7 $ sq• ft.
o Main Floor: 2. g -S sq, R.
o Additional Floors: 103 Q sq. R•
Lot #: Block #: 4 Subdivision: C AJ VOAN Ute--kESS,`
# of Water Meters: I Water Meter Size: 5 gk 3 If
Fireplace(s) Being Installed? 0 Yes D No
o Basement: N/t�— • Hydronic Heating Being Installed? ❑ Yes JX No
Finished 0-p sq. R•
Unfinished 0 sq, R• Building Permit fees for new homes are charged based on square
o Garage r sq. IL footage and the City's estimated valuation. For details on how fees
• Estimated Total Cost: $ `Z I C1 .0c) o are calculated, contact the Building Department. There will also be
a plan review fee totaling 10% of the building permitfee.
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. I agree rr 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 correct.
I agree
t 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): SRTrA ,,l �t;;
Signature: Date:
�✓ ZO
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
C I T Y O F Building Safety Department
�> 70 REXBLJRG BUILDING PERMIT FORM 110 City of Rexburg
OW __ _.__ _ Upda[ed 10/2016
Americas Family Communio. 3S North 1St East
Rexburg, Idaho 83440
BUILDING APPLICATION
New SFR Mechanical
_,' 13ti,:e I14r
Permit Number:
Property
❑ Mechanical Fee Paid
Name: v nl
Address: "
Phone:u%1iS City: R+ ntrux2�� State: iD Zip Code: 234�i
Email: bu,A i 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?
JX Yes (Skip to -_; and complete the Homeowner's Exemption)
❑ No, I am working with the homeowner
2. Mechanical Contractor
Business:
Address: State License #: Exp.:
Phone: CIS'' State-, Zip Code:
Contact/Rep. Name: Email:
Phone: Email:
Mechanical Contractor Authorized Signature:
Date:A copy ofyour state registration/license is required to be on file. If this 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 Description
Address:
Description of work:
1ASFR Construction: _3 (,?
sq. ft
-OR- Lot #: 2 Block #: Subdivision:
Fees for new construction are charged by square footage: Up to 1,500 sq. f - =$130 + $65 for each additional 1,000 sq. ft or
Portion thereof.
0 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 s _ $325, etc. (i.e. aq. ft
home with 3,675 sq. ft, will be charged $325)
ef Number of Fireplaces:
• Note that fireplaces are not included in square footage costs and will be charged $65 per inspection.
E(Hydronic Heating: Q
• Note that hydropic heating is not included in square footage costs and will be charged and additional $65 + ($10 x # 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 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): L�,V �7£�►S
Signature: .46
_ Date:
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests din after 8 AM will be scheduled for the next business day.
Inspection Hotline - (208) 372.2344
www.rexburg.org Permit Technician - (208) 372.2341
OF µti X6tlRr.
C IT v OF Building Safety Department
REXBtJRG BUILDING PERMIT FORM
- C 12 O City of Rexburg
'• ly -- Updated 10/2016
America' F'amilyCommunity 35 North 1St East
Rexburg, Idaho 83440
BUILDING APPLICATION
New SFR Electrical
Office Use,
Permit Number:
❑ Electrical Fee Paid
�.. 'roperty Owner
Name: _S14Atnlypi V TcnfCc �{
Address:
Phone: CIS'' — � mail �"6' State: _0 Zip Code:_. 3 ;,4 �
-(2�1) 2<.�l –��t5 3 Email: � �.o4P n5h
Under Idaho Building Code, a homeowner is allowed to do work on their own home, t e�
Are you a homeowner doing work on your own home?
%Yes (Skip to - :' and complete the Homeowner's Exemption)
❑ No, I am working with the homeowner
2. Electrical Contractor
Business:
Address: State License #: Exp.:
Phone:
City: State: Zip Code:
Contact/Rep. Name: Email:
Phone: Email:
Electrical Contractor Authorized Signature:
A copy ofyour state registration/license is required to be on file. If this 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 Description
Address: -OR- Lot #: 2 Block #:
Description of work: Rrt,+ 12(11t4 , �Subdivision:CfM,�lc:r.�
�b �g n �-t
Pq New SF!, 1 Gii°;�".''llCt1011 �j(a 7
sq. ft
• Fees for new construction are charged by square footage: Up to 1,500 sq, ft = $130 + $6S for each additional 1,000 s .
portion thereof, sq.ft. or
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)
❑ Spas/Pools/Generators: ❑ Yes 0 No
• 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, l 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): S'A, nl t� V , 7,%tiS:_,N Signature: to
_Date:.
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after8 AM will be scheduled for the next business day.
Inspection Hotline - (208) 372.2344
www.rexburg.org Permit Technician - (208) 372.2341
,` µFXBG'Rr
71 C' TY o F Building Safety Department
^i REXBURG BUILDING PERMIT FORM 13 0City of Rexburg
[y, Updated 10/2016
America' F'amilyCommunity' 35 North 1St East
Rexburg, Idaho 83440
BUILDING APPLICATION
New SFR Plumbing
Permit Number:
❑ Plumbing Fee Paid
. 'r'�iperty Owner
Name: _S[kgWrj V.
Address:
City: 2F k�+tt26i State:
Phone: 2c i �yc i�-oc� 5 3 _1L___,_ Zip Code: cg3et0
Email: _ `�ery�nsh_ Ca 1�y�uLj
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?
°KYes (Skip to = and complete the Homeowner's Exemption)
❑ No, I am working with the homeowner
Plumbing Contractor
Business:
Address: State License #: Exp.:
Phone: Cly'' State: Zip Code:
Contact/Rep. Name: Email:
Phone: Email:
Plumbing Contractor Authorized Signature:
A copy ofyour state registration/license is required to be on file. If this is the first time you have done work in the City ofRexburg, pleaseprovide
a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
:.'ri)ect Description
Address:
Description of work: i -h h L� r\ -OR- Lot #: Block #: Subdivision:
>` 1 Nl5 tt i>_.3 U4 ✓ -11, P ku '3 -sem i k,,..,
KNew SFR Construction
`3---'7,�--, —sq.fL
Fees for new construction are charged by square footage: Up to 1,500 sq. ft = $130 + $65 for each additional 1,000 sq. ft or portion
thereof
o home with 3, 675 s $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
���,,��� q fk will be charged $325)
/tJ°/Hydronic (In -floor) Heating: ❑ Yes IM No
• Note that hydropic heating is not included in square footage costs and will be charged $65 + ($10 x # 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 I swear that any information which may hereafter be given by me in bearings 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): 51 tJ \L 34S r nS Signature: 1c
Date: 95 ► 0Zim
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
CITY O F
REXBuRG
Americas Family Community
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
SUBCONTRACTOR LIST
Excavation & Earthwork: %z n, V -� L,,v= r -
i
Concrete:
Masonry:
Roofing:
Insulation: -:,;Fn v�� u,►
Drywall:
Painting:
Floor Coverings:
Plumbing: LF r PEyL�
Heating:
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses:
Floor/Ceiling Joists:
Siding/Exterior Trim:
Other: 77A-,� 1 A I A,
W;F S
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
Revised 10/2016
., C i TY OF Building Safety Department
RExBuR T City of Rexburg
OW --
AmerictAFamuyCommunity 35 North 1St East
Rexburg, Idaho 83440
HOMEOWNER'S EXEMPTION
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. A homeowner may do work on the owner's
own home. If this applies to you, please sign this form declaring your exemption from registration and return it
with your permit application.
Idaho State Statute allows a homeowner to do work on their own residence:
An owner performing construction on the owner's personal residential real property, whether or not occupied by
the owner, provided however, this exemption shall not apply to an owner who is otherwise regulated by this chapter
who constructs a building, residence or other improvement on the owner's property with the intention and for the
purpose of promptly selling the improved property, unless the owner has continuously occupied the property as the
owner's primary residence for not less than twelve (12) months prior to the sale of such property;
Title 54, Chapter 52, Subsection (2)
I hereby certify that the above information is true and correct to the best of my knowled;?e.
-t.
Signature
Print Name
_- � Tf' l �je4j
Date
Permit Technician — (208) 372.2341
www.rexburg.org Revised 2/2017
C' T'' OF Building Safety Department
REXBuRG City of Rexburg
Ameria,'s family Community
35 North 1St East
Rexburg, Idaho 83440
Affidavit of Legal Interest
State of Idaho
County of Madison
C�� Eli `7E f—As-,r sTlk S,ic�tZ-1
Name Address
City
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, sldp to B)
State
A. That I am the record owner of the property described on the attached, and I grant my permission to:
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 herein or as to the ownership of the property
which is the subject of the application.
Dated this
day of
Signature
20
Subscribed and sworn to before me the day and year first above written.
Notary Public of Idaho
Residing at:
My commission expires:
inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
Revised 10, 2016
O� LVx8I:
r Building Safety Department
1iG
G City of Rexburg
Americas Family Community 35 North 1St East
Rexburg, Idaho 83440
DISTRIBUTION LIST
Please provide the names and emails of anyone who should begetting automated updates for this project:
Review Notes
Name: 51 rO4&y g
Name: V° t u4yla-v,
Name:
Name:
Name:
Inspection Tickets
Name:
Name:
Name:
Name:
Name:
Email:
Email: �e�spv� , h�lcrr W�ct� �, C0s,�
Email:
Email:
Email:
Email:
Email: " mss, , hL-.,%r
"'�4 � j • cam-,
Email:
Email:
Email:
Inspection Hotline - (208) 372.2344
www.rexburg.org Permit Technician - (208) 372.2341
Revised 1OJ2016