HomeMy WebLinkAboutAPPLICATION - 19-00156 - 433 Airport Rd - Barney Self Storage Plus - Bldg 7aQ aexauR�
CITY OF
REXBURG
0&
America's Family Community
Building Safety Department
COMMERCIAL APPLICATION CHECKLIST
City of Rexburg
35 North 1St East
Rexburg. 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:
❑ 3 sets of site plans drawn to scale (see Site Plan Checklist)
❑ 3 sets of building plans (see box below to right) -stamped by a licensed professional.
Include the following as applicable
❑ Foundation Plan, Floor Joist Layout, Floor Plan, Roof Layout, Truss Details, Sectional Views, Front, Back, and Side
Elevations, Mechanical Layout, Stair Details, and any details required to illustrate special construction.
❑ Electrical panel layout and calculations included with building plans.
❑ Exterior Lighting Plan including photometric layout.
❑ Structural Calculations (see box below) - stamped by a
licensed Engineer
❑ Energy Compliance Report: As per the 2015 IECC, a COMCheck
is required (available online at www.energycodes gov)
❑ 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
❑ Site Plan Checklist
❑ Permit Policies Acknowledgment signed
Seismic Design Category - D
(unless soil evaluation confirms category C)
Ground Snow - 50 lbs. per sq. ft.
Roof Snow Load - 35 lbs. per sq. ft.
Wind Load - 90 MPH
Frost Depth - 36"
❑ Property Line form 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 licensed Electrical Contractor
❑ Plumbing Permit Application signed by a licensed Plumbing Contractor
❑ Fire Alarm Permit Application (if applicable) signed by a registered professional
❑ Fire Sprinkler Permit Application (if applicable) signed by a registered professional
❑ Subcontractor list filled out
❑ Affidavit of Legal Interest signed by owner
❑ Notifications Distribution List
❑ Business Use Summary Completed
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 httl2:llrexbuEg.org/pages./development-code.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician -208
( ) 372.2341 Revised 10/2016
CITY O F
REXBURG
Americas Family Community
Community Development Department
City of Rexburg
35 North 1St East
SITE PLAN CHECKLIST
Rexburg, Idaho 83440
❑ 1. Legal Description of proposed building site
1:12. North Arrow
❑ 3. Drawn to scale
❑ 4. Lot Dimensions
❑ 5. Building locations, and dimensions with distance to property lines and distances between buildings
❑ 6. Distance of entrances from street corners dimensioned
❑ 7. Show 10% snow storage area
❑ 8. Drainage Plan (with arrows)
❑ 9. Fencing/Screening
❑ 10. Landscaping/Buffering
❑ 11. Lighting Plan (if needed)
❑ 12. Existing and proposed easements
❑ 13. Existing utilities (waterlines, sanitary sewer lines, manholes, storm drains)
❑ 14. Existing right-of-way location and width, curb to curb widths
❑ 15. Existing streets labeled
❑ 16. Proposed street improvements (curb, gutter, sidewalk, pavement, etc.)
❑ 17. Parking (Lot dimensions, distance between rows, loading areas if required)
❑ 18. Sidewalks - both along rights-of-way and internal (existing and proposed)
❑ 19. Fire hydrants and fire suppression lines (including tie to City lines)
o Sprinkled
o Not Sprinkled
❑ 20. Fire apparatus access
❑ 21. Proposed utilities including tie in location to existing services and new easements
❑ 22. Proposed storm drain and sanitary sewer elevations (for pipe inverts at manholes and catch basins)
❑ 23. Trash facilities (dumpsters for right-hand truck)
0 1 Dumpster per 20 doors (non -dormitory)
0 1 Dumpster per 50 beds (dormitory)
❑ 24. Numbers needed:
o Building square footage
o Percent of lot covered by building
o Paving Area
o Drainage Plan Calculations
o Parking space numbers (tenant & visitor, handicap, private)
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) 359.3020 Revised 3/2018
CITY O F
REXBURG
nv
America's Family Community
PERMIT POLICIES ACKNOWLEDGMENT
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg. Idaho B3440
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 i
proceeding with your project.
o APPROVAL OF CONSTRUCTION. 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
iais 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) 372-2167. 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.
o SCHEDULING INSPECTIONS. 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
itiai following business day. 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 be removed in order to perform the electrical rough in inspection.)
o STAIRWAYS REQUIRED. On jobsites for multi-level buildings the contractor must provide temporary stairs so that
workers and inspectors can safely access upper levels of the building. If these stairs are not provided, inspections may
I01tials not be completed. Extenuating circumstances will need to be approved by the Building Department.
o DIGITAL AS -BUILT PLANS. 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 Certificate of
in is Occupancy will be issued without these plans, extenuating circumstances will need to be approved by the Building
Department.
OCCUPYING A FINISHED BUILDING. No building may be occupied without receiving a signed Certificate of Occupancy. If a
building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the occupants may
i lal be required to vacate.
ealsMAKING KNOWN POLICIES. 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
i information is passed on to them or not.
Applicant's Name (print): Signature: N Date: pS I
Inspections must be called in before 8Mon the day th spection is requested. Inspection requests called in after 8 AM will be scheduled for the next business day.
Inspection Hotline - (208) 372.2344 ww.rexburg.org Permit Technician - (208) 372.2341 Revised 10/2016
CITY OF
REXBURG
nv
Americds Family Community
PROPERTY LINES
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
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. If you want to request a copy of your lot, see the front counter at the Community
Development Department.
I have read and understand the above requirements.
Signature
Prin ed Name
er
Date
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 Revised 10/2016
oQaeXa N
U O
CITY OF
REXBURG
CW
America's Family Community
BUILDING PERMIT FORM 200
Updated 03/2017
BUILDING APPLICATION
New Commercial Building
Building Safety Department
City of Rexburg
3S North 1St East
Rexburg, Idaho 83440
For Office Use
Permit Number: Zoning: Application Fee: ❑ $1000/Building
1. Property Owner
Name: U2 It ` _-� %J `,lam
Address: 0 0 /6 c 3'� / City: /?e -,f -,f b L, r S State��a U Zip Co
de: 03 7 7 U
Phone: o/ 66'7 //31 Email: /Yi rL n 5 e 1— /92 .5e ?4'_ 57`o r S� p 4 .
J�
2. Applicant
Name: r ✓l 2 I Role: Owner, Tenant, Contractor, etc.) "
Address: �0 �5 i'r o ity: e k ( ' State: Zip Code: U
Phone: G % �i4 S Email: bA >WL-
Contact/Rep. Name: 1
3. General Contractor
Under Idaho Building Code, a re istered co>�trar�tor must do the work for a Commercial Building.
Name: 6) �'` 9 UI Registration #: Exp.:
Address:City: State: Zip Code: _
Phone: Email: _
Contact/Rep. Name: Phone: Email:
General Contractor Authorized Signature: Date:
A copy of your state registration/license is required to be on file. If this is the first time you have done work in the City of Rexburg, please provide
a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
4. Project Description f�
• Address: 413 3 n P ' 1 -OR-/, Lot #: Block #: Subdivision:
• Project Name:$Q /f S'ilo(1QS @,P/NS Q 4 i IG r'h5' e Construction Type:..!! • Occupancy Type: `�-2
• Square footage: -?.600 • Total cost of project -materials and labor: $
• Check all disciplines that apply: ❑ Mechanical: Cost $ ❑ Electrical: Cost $
❑ Plumbing: Cost $_ ❑ Fire Alarm: Cost $ ❑ Fire Sprinkler: Cost $_
Note: Any contractors involved will need to fill out their respective application.
• # of Water Meters: 0 • Water Meter Size(s): O . # of Parking Stalls:
• # of Dumpsters: G . Estimated Dumpster Delivery • # of Dumpster Pickups/week
Date: / / / 1 3 4 5
• Other Comments (if any): e / C C 4 � 'c- -_LT_
%9 f �` 66 f 7 Ind i 11 � E f2 111"J 5, P, r1.1
Building Permit fees for commercial construction are charged based on square footage and the City's estimated valuation. The
application fee applies toward the fee total. For details on how fees are calculated, contact the Building Department. There will also be a
plan review fee totaling 10% of the building permit fee.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I have read this application and state that the information herein
is correct and I swear that any information which may hereafter be given by me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg
shall be truthful and correct. I agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the
City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2012
International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not
started within 180 days. Permit void if work stops for 180 days.
-c K,\,
Q /Applicant's Name (print): j2- Signature: / ate:
Inspections must be called in before 8 AM on the day the ins on is requested. Inspection requests called in after 8 AM wilt c c eduled for the next business day.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
��OF gEXB U$C G CITY o F Building Safety Department
r
REXBy1tG BUILDING PERMIT FORM 210 City of Rexburg
°pd °3i2019 35 North 1St East
America's Family Community Rexburg, Idaho 83440
COMMERCIAL MECHANICAL BUILDING APPLICATION i
❑ New Construction ❑ Addition ❑ Remodel ❑ Tenant Improvement ❑ Accessory Str ture > 200 sq, ft.
For Office Use
Permit Number: Mechanical Fees Paid ❑
Property Owner
Name:
Address:
Phone:
City:
2. Mechanical Contractor
Under Idaho Building Code, a registered contractor must
Business:
Address:
Phone:
Contact/Rep. Name:
City:
Phone:
Zip Code:
Email:
worke a Commercial Building.
Lic se #: Exp.:
State: _ Zip Code:
Email:
Mechanical Contractor Authorized Signature: ti Date:
A copy ofyour state registration/license is required t e on file. I his is the first time you have done work in the City of Rexburg, please provide
a photo copy ofyour license. Ifyou are unsure ifyour li nse is file, please check with the Permit Technician by calling (208) 372-2341.
3. Project Description
Address:
Description of work: _
❑ Project Cost: $
Cost o roject:
Calculation for inspection fee:
$0 to $10,000 then:
(Cost of project * 2%) + $60
0,000 to $100,000 then:
((Cost of project - $10,000) * 1%) + $260
eater than $100,000 then:
((Costofproject - $100,000) * �%) + $1160
An a yitional plan review fee is required which is 10% of the calculated inspection fee
APPLICANT'S SIGNATURE, CERTIFICAT N 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; inform ion 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 agre o 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 -men oned 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 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. Per it void if work stops for 180 days.
Z
//—/
Applicant's Name (print): , Signature: Date: r
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after SAM will be scheduled for the next business day.
Inspection Hotline — (208) 372.2344 www.rexburg.org Permit Technician — (208) 372.2341
CITY OF
REXBURG
America's Family Community
BUILDING PERMIT FORM Z 2
Updated (13/2019
Building Safety Department
City of Rexburg
3S North 1St East
COMMERCIAL ELECTRICAL BUILDING APPLICATION
Rexburg, Idaho
❑ New Construction 171 Addition C1 Remodel El Tenant Improvement 13ccesswy St ruc re > 200 sq. ft
For Office Use
Permit Number: i U P�ectrtral�Fees Paid ❑
1. Property Owner
Name:
Address:
Phone:
City:
2. Electrical Contractor
Under Idaho Building Code, a registered contractor must do
Business: c
Address: City:
Phone: jj��''
Contact/Rep. Name: Phorl�e:.)
Email:
C
Code:
f Commerc' 1 Building.
#: V Exp.:
C8tate: _ Zip Code:
Email:
F`
Electrical Contractor Authorized Signature: � Date:
A copy ofyour state registration/license is required to be on file. l his is the first ti e you have done work in the City of Rexburg, please provide
a photo copy ofyour license. lfyou are unsure ifyour license isy file, pleaseFieck with the Permit Technician by calling (208) 372-2341.
3. Project Description
Address:
Description of work:
❑ Project Cost: $
C t f proj ct:
Calculation for inspection fee:
$0 A $10,000 =
(Cost of project * 2%) + $60
0,000 0-A00,000 =
((Cost of project - $10,000) * 1 %) $$260
G ea er an $1 0,000 =
((Cost of project - $100,000) *'fa%) + $1160
0
N�nere will also be a plan review fee totaling 10% of the above fee.
APP ICANT GN TURE, C TIFICATiON AND AUTHORIZATION: Under penalty of perjury, i hereby certify that i have read this application and state that the information herein
is c rrect an 1 ar t t y 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
sha be tru Ful and cor ct. 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 en r upon the ove-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2012
Intern anal Code ;d,/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 in 1 days. Permit void if work stops for 180 days.
Applicant's Name (print): fl :5"n'� Signature: ��--�'1 Date: -t ! ��
IVB /
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM w,,}! lie scheduled for the next business day.
Inspection Hotline — (208) 372.2344 www.rexburg.org v° Permit Technician — (208) 372.2341
o�4exsuRc
U� r� CITY o f Building Safety Department
»1EXy1MG BUILDING PERMIT FORM 230 City of Rexburg
� Updated U3/2079 35 North 1St East
America's Family Community Rexburg, Idaho 83440
COMMERCIAL PLUMBING BUILDING APPLICATION
❑ New Construction ❑ Addition ❑ Remodel ❑ Tenant Improvement ❑ Accessory Structure > 200 s . ft
For Office Use
Permit Number: Plumbi Fees Paid ❑
1. Property Owner
Name:
Address: City: State: /pCode:
Phone: Email:
2. Plumbing Contractor
Under Idaho Building Code, a registered contractor must do the
Business:
Address:
Phone:
Contact/Rep. Name:
State Lic
City:
Email:
Phone:
Plumbing Contractor Authorized Signature:
A copy ofyour state registration/license is required to be on�isn
ffile,
a photo copy ofyour license. Ifyou are unsure ifyour license
Project Description
Address:
Description of work:
❑ Project Cost: $
a Comm al Building.
#: Exp.:
Zip Code:
Email:
tl-- Date:
me you have done work in the City of Rexburg, please provide
with the Permit Technician by calling (208) 372-2341.
Clost of project:
Calculation for inspection fee:
$0 to 10,000=
(Cost of project * 2%) + $60
$10,000 $100, 000 =
((Cost of project - $10,000) * 191o) + $260
Greater han $100,000 =
((Cost of project - $100, 000) * i/z%) + $1160
review fee is required which is 10% of the calculated inspection fee
APPLICANT'S SIGNATURE, CERTIFICA N AND A HORIZATION: 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 informati whic ay 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 co pl ith 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 pr erty for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the p rovisions of the 2012
International Code in cases of any false tement 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 ' work stops for 180 days.
li o� > _ L —
Applicant's cants 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.rexburg.org Permit Technician - (208) 372.2341
CITY OF
REXBURG
America's Family Community
Building Safety Department
BUILDING PERMIT FORM401 City of Rexburg
Updated 03/2019 35 North 1St East
Rexburg, Idaho 83440
COMMERCIAL FIRE ALARM BUILDING APPLICATION
❑ New Construction ❑ Addition ❑ Remodel ❑ Tenant Improvement
For Office Use
Permit Number:
1. Property Owner
Name:
Address:
Phone:
2. Contractor
Business:
Phone:
Contact/Rep. Name:
City: State:
Email:
State License #:
City: sta
Email: ���
Phone:/Email:
Contractor Authorized Signature: I )
A copy of your state registration/license is required to be on file. f this is
a photo copy ofyour license. Ifyou are unsure ifyour lignse is o file, ple
3. Project Description
Address:
Description of work:
❑ Fire Alarm System Cost: $ _
• Fees are Viged by
14
o Work i
Fire Alarm Fees
Zip
Exp.:
- Zip Code:
Date:
me you have done work in the City of Rexburg, please provide
with the Permit Technician by calling (208) 372-2341.
INITIA OST
CHARGE BY COST
$0 $10,000 =
(Cost of project *2%) + $60
$ Wo to $100,000=
((Cost of project - $10,000) * Mo) + $260
Gr ater than $100,000 =
((Cost of project - $10,000) * 0.5%) + $1,160
15,U00 will be charged $260 for the first $10,000 and 1% of the remaining $5,000 =$260 + $50 =$310 total fee
• There w}lf also be a plan review fee totaling 10% of the above fee
.APPLICANT'S SIGNATUI;k, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I have read this application and state that the information herein
correct and I swear th 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 corm I agree to comply with all City regulations and State laws relating to the subj ect matter of this application and hereby authorized representatives of the City
to enter upon the ove-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2012
International C e 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 withi 80 days. Permit void if work stops for 180 days.
�
Applicant's Name (print): CJ fi�
' mature:
Inspections must be called in before 8 AM on the day the' Zi.nequested. Inspection requests called in after 8 AM will
Inspection Hotline – (208) 372.2344 www.rexburg.org
1 �9
3iness day.
—1 iecnmuan–(208) 372.2341
CITY O F
REXBURG
America's Family Community
BUILDING PERMIT FORM 4,02
Updated 03/2019
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
COMMERCIAL FIRE SPRINKLER BUILDING APPLICATION
❑ New Construction ❑ Addition ❑ Remodel ❑ Tenant Improvement
For Office Use
Permit Number: �rerinkler
Fees Paid ❑
1. Property Owner
Name:
Address: City: SXtat. Zip Code:
_
Phone: Email:
2. Contractor
Business: State License Exp.:
Address: City: State: Zip Code:
_
Phone: Em '
Contact/Rep. Name: Phone: Email:
Contractor Authorized Signature: Date:
-
A copy of your state registration/license is required to be on file. If is 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 o flle, please check with the Permit Technician by calling (208) 372-2341.
3. Project Description
Address: F
Description of work:
Number of Heads:
❑ Fire Sprinkler System Cost: $
• Fees are charged qy�c t:
ITIAL COST CHARGE BY COST
$0 to $10,000 = (Cost of project * 2916) + $60
10,000 to $100,000 = ((Cost of project - $10,000) * 1 %) + $260
reater than $100,000 = ((Cost of project - $10,000) * 0.5% + $1,160
0 Wor Gostin $15,000 will be charged $260 for the frst$10,000 and 1% of the remaining $5,000 = $260 +$50 =$310 total Fee
• There wi also be a plan review fee totaling 10% of the above fee.
APPLICANT'S SIGNATU , CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I have read this application and state that the information herein
correct and I swear th 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 corre . 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 thea ove-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2012
International _/-mentioned
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 0 days. Permit void if work stops for 180 days.
Applicant's Name (print): ,�26(- c.. Signature: te:
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM will be sche ed for the next business day.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
OF gEXSURC
.� �7 CITY O F
REXBURG
'• America's Family Community
SUBCONTRACTOR LIST
Excavation & Earthwork: 'D
Concrete: L at in w e O i
Masonry:
Building Safety Department
City of Rexburg
3S North 1St East
Rexburg, Idaho 83440
Roofing:
�.
Insulation:
Drywall:
Painting:
Floor Coverings:
Plumbing:
Heating:
Electrical: 19"2, Ci- �� n 2 ��-- e C i t1 C
Roof Trusses:
Floor/Ceiling Joists: _
Siding/Exterior Trim:
/�
Other: � J ► 13 t\'
Special Construction
(Manufacturer or Supplier)
(`4 i 5 j0P(Z-5t-- L.)(nr )k�
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 Revised 10/2016
oQ gEXBUAC
CITY OF
REXBURG
Ob
'•<,, E p ,.' Americas Family Community
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho,'3440
Affidavit of Legal Interest
State of Idaho
County of Madison
I,
Name
City
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 owner of the property esc
Name Address
Address
State
d onAe attached, and I grant my permission to:
to submit the accompanying applica 'o/pern' g to that property.
B. I agree to indemnify, defe d anurg City and its employees harmless from any claim or liability
resulting from any disp. e as oents contained herein or as to the ownership of the property
which is the subject of the ppli
Dated this
Subscribe
of
20
y' Signature
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
CITY OF
REXBURG
006
Americas Family Community
DISTRIBUTION LIST
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
Please provide the names and emails of anyone who should be getting automated updates for this project.-
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Review Notes
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Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 Revised 10/2016
CITY OF
REXBURG
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America's Family Community
BUSINESS USE SUMMARY
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
The following questions will help speed the review process along. Please take the time to answer all of them.
Is this business occupying an existing building?
Will the business be doing any structural/or remodeling changes to the building?
Any changes to the electrical?
Any changes to the plumbing?
Any changes to the mechanical system?
Is the business type changing? ❑ Yes, it will change to
Is this business changing ownership?
❑ Yes tko
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❑ Yes �No
❑ Yes .moo
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El�\Yes �No
Is the business registered with the City of Rexburg?�es, License #: � ❑ No
*If No, please apply for a business license with the Customer Service Dept.
Will the business have food preparations? ❑ Yes E/
Will there be any cooking of foods?
Will there be any deep fat frying?
Will you have food disposal on site?
Will there be sumps or floor drains in the facility?
Will the business have any chemicals on site?
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Date
I certify that the information that I have provided above is to the best of my knowledge accurate and true.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 Revised March, 2016