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HomeMy WebLinkAboutAPPLICATION - 19-00154 - 1450 N 2nd E - Walmart - Grocery Pickup Additionci'iY yr REXBURG .Lrtr..a;,h»dh PPPvfv U5c I"Xi ioret. to Entail 01i cr; Use Only Registi +tion No. Fe& -s Paid SIC APPLICATION FOR CERTIFICATE OF BUSINESS REGISTRATION No person shall maintain or operate any business, trade, or occupation within the corporate limits of the City of Rexburg without first obtaining a Certificate of Registration from the City of Rexburg and paying a general fee. Certificates of Registration shall be issued to each applicant complying with all applicable state laws and city ordinances. ` GENERAL INFORMATION APPLICATION PURPOSE ❑ New Business ❑Renewal ❑ New Location ❑ New Owner ❑ Remodel ❑✓ Other Change LEGAL NAME OF BUSINESS G.M. Northrup Corporation TRADE NAME (doing business as) G.M. Construction STATE TAX ID # 41-1 56541 5 TYPE OF BUSINESS (Check One) ❑ Sole Proprietor OCorp. ❑ LLC ❑ Partnership 1:1 Other NATURE OF BUSINESS (Check all that Apply) ❑ Manufacturing ❑Wholesale El Retail ❑Services ❑Food Services ❑ Professional ❑� Contractor/Trade El Rental (Appendix A) ❑Beer (Appendix B) ❑Fireworks (Appendix C)❑Peddler, Solicitor, Itinerant Merchant or Mobile Vendor (Appendix D) ❑ Home Occupation (Appendix E) ❑Pawnbroker or Secondhand Dealer (Appendix F)❑Towing & Booting (Appendix G) ❑ Wine (Appendix H) []Use of City Sewer (Appendix I & J) ❑Public Transportation (Appendix IQ DESCRIBE IN DETAIL THE PRINCIPAL PRODUCT(s) OR SERVICE(s) RENDERED: P AWP2241.21-) �' /z/ c �l Business Web Address: APPLICANT'S DRIVERS LICENSE NO. NAME OF OWNER[ /APPLICANT La°Y Address ! c' % f 411, NAME OF PROPERTY OWNER 4 0 Address /��� AFTER HOURS EMERGENCY CONTACT Address rules, ��✓�'� CONTACT INFORMATION Ll,-? 10 ----) 1-7/-5 State /'I/ w r� Phoned" 1 Email V(C, l IYIY7I r4i r -Q D. Phone o ' - Email a),4n4 haud-,C-R ;(!r-a�_r'• PhoneUfS' ex SITE DESCRIPTION ZONING APPROVAL: Date Obtained Zoning Approval by: to obtain zoning and signage requirements) Contact City Hall at 359-3020 PHYSICAL BUSINESS ADDRESS _ Please indicate if ou approve providing this physical address, web address, and/or phone no. to the city's web site: Yes No MAILING ADDRESS _ BUSINESS PHONE SIGNAGE: Applicants wanting a sign must apply for a sign permit. Applications are at City Hall or at www.rexburg.org. YJw� DEVELOPMENT CODE REQUIREAENTS STAFF REVIEW: Development Code Approval by: (Contact City Hall at 359-3020 to obtain approval) WASTEWATER PERMITTING & BUILDING COMPLIANCE What type of business will be performed? This is an existing Walmart store **Will the business have food preparations? Yes ❑ No 1-1 **Will there be any cooking of foods? Yes F] No n **Will there be any deep fat frying? Yes F-1 No II 'Will you have food disposal on site? Yes No n Will there be any maintenance or mechanical work in the building? Yes No 1:1 **Will there be sumps or floor drains in the facility? Yes No F1 Will the business require more parking? Yes 11 No F] **Will the business have any chemicals on site? Yes F-1 No Is this business occupying an existing building? Yes No Will the business be doing any structural/or remodeling changes to the building? Yes No Any changes to the electrical? Yes ❑ No **Any changes to the plumbing? Yes ❑ No Is this business planned to be the same with different ownership? Yes ❑ No 11 Will there be a change of occupancy? Yes 1:1 No l� I certify that the information that I have provided above is to the best of my knowledge accurate and true. **IF YOU ANSWERED YES TO ANY OF THESE QUESTIONS, PLEASE COMPLETE APPENICES I AND J. IMPORTANT: Incomplete or incorrect applications may result in delay or refusal of issuance of Certificate of Registration. Except where otherwise provided, the certificate year/term shall run from January 1 sc until December 315 of the same year The certificate must be renewed yearly a,rnjd, the a;)plicable fees must be paid yearly AS APPLICANT, I �� / �'!iJ'� DECLARE UNDER PENALTY OF PERJURY UNDER IDAHO STATE LAW THAT ALL INFORMATION MEN IS TRUE AND CORRECT, AND I UNDERSTAND THAT ALL INFORMATION GIVEN IS SUBJECT TO VERIFICATION. 15:� ,�'1� Applicants Signature --a Phone Date "PLEASE ATTACH ANY APPLICABLE APPENDIX (See general information above), AND ENCLOSE A CHECK FOR ALL APPLICABLE FEES MADE PAYABLE TO THE CITY OF REXBURG. OFFICE USE ONLY - APPROVAL CHECKLIST— PLEASE INITIAL CODE REVIEW ECON DEV FIRE DEPT CITY CLERK WASTEWATER y.t.x+ri3n CITY OF 4 W REXBURG Americzt's Rimily Commurdty +tn BUILDING PERMIT FORM Z 1 Updated 05/2019 BUILDING APPLICATION Commercial Remodel/Tenant Finish Building Safety Department City of Rexburg 35 North 1St East Rexburg, Idaho 83440 For Office Use Permit Number: Application Fee: ❑ $100 1. Property Owner r'YGf Name: , Address: City: /;?Lk bvcc State: Zip Code: Phone: Email: Lc�£c�`�✓ Lu�7r1r rte. CAi 2. Applicant , / Name: N. !U f -fi Role: (Owner, Tenant, Contractor, etc.) ✓I7 i�rr" dry Address: 5 ~ �`,►' �� City: %i!v/ die State: IMAJ Zi Code:S Phone: '2 � 2-Z (c uC.� Email: ' f. 7 n!J . t" 3+�► Contact/Rep. Name: Ari(rr 3. General Contractor Under Idaho Building Code, a registered contractor must do the work for a Commercial Building. Name: & /A , VOr-A1/ 1- ?©/' 10- rOkJ Registration #:.► e ,.2533 C Exp.: /3 20 2 Address: Z5 50 � r` � ri S6 City: 1�I'r`�r" rte' State: Zip Code: 5rS37c Phone: 96-+ - 0a b - 50 90 Email.• kV411W Contact/Rep. Name: I}%Xe-t' /12�L1y"� 5fJ�7 l' Iu:✓+ �General Contractor Authorized Signature: Date: ir.J4 h9 A copy ofyour state registration/license is required to be on r `'this ry the first time ypu have done work in the City of Rexburg, p4ase provide a photo copy ofyour license. /fyou are unsure ifyour iicclr� son file, please check with the Permit Technician by calling (208) 372-2341. L Descrlpl l oll Address: 1451) Y Description of Work: ,,�; �:r•<r�:�+yrr Project Description: • Total cost of project - materials and labor: $ ¢a • �� • Check all that apply: 4 / EV/Mechanical: Cost $ I Ov0• lir Electrical: Cost $fid • 13 Plumbing: Cost 0 ❑ Fire Alarm: Cost $ &/Fire Sprinkler: Cost $ G .1 Note: Any contractors involved will need to fill out their respective application. • Change of Occupancy?No ❑ Yes: New occupancy: 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 mein 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 a ereby authorized representatives of the City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on app ,sued u� er 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 whi the per approv as based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Applicant's Name (print): IAC/&/ Nor/'i5On Inspections must be called in before 8 AM on the day the inspection is requested. Inspection Inspection Hotline - (208) 372.2344 www.rexburg.org /Date' Ap in after 8 AM will be scheduled l h e rislRess day. Permit Technician - (208) 372.2341 �atixeL'k CITY l' Y 0 P Building Y I� Safety Department ` REXBURG City of Rexburg } 0 3S North 1St East 0, America's FamilyC.ommwnity PERMIT POLICIES ACKNOWLEDGMENT 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 M 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 Initials 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 INS PECI IONS. Scheduling inspections is the responsibility of the applicant and their contractor. Inspections MQ%r 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. If an inspection is not done, the inspector may require any measures to be taken to allow him to Initials 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 �� )r workers and inspectors can safely access upper levels of the building. If these stairs are not provided, inspections may Initials not be completed. Extenuating circumstances will need to be approved by the Building Department. DIGITAL AS -BUILT PLANS. A Certificate of Occupancy will not be issued without digital copies of the As -Built Plans. It is �4 the Applicant's responsibility to turn in digital copies of the As -Built Plans when the project is completed. No Certificate of Initials Occupancy will be issued without these plans, extenuating circumstances will need to be approved by the Building Department. o CICCUPYINGAFINISHEDBUILDING.Nobuilding may beoccupied without receiving asigned Certificate ofOccupancy. Ifa building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the occupants may nitials be required to vacate. o MAKING 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 Initials information is passed on to them or not. Applicant's Name (print):. 6I�.CiJ 46-I'75d ) Signature Date: Inspections must be called in before 8 AM on the day the inspection is requested. Inspection r esrs called in after 6 AM will be scheduled for the next business day. Inspection Hotline — (208) 372.2344 www.rexburg.org Pd. Init Techalvlan — (208) 372.2341 Revised 10/2016 CITY O F REXBURG ----01W --- America's Family CommunRy 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?` Yes ❑ No Will the business be doing any structural/or remodeling changes to the building? 'Yes []No Any changes to the electrical? :Yes ❑ No Any changes to the plumbing? Yes [:]No Any changes to the mechanical system? []Yes ❑ No Is the business type changing? ❑ Yes, it will change to Is this business changing ownership? ❑ Yes ryN o Is the business registered with the City of Rexburg?'O Yes, License #: �/CZ/VY1Gcf� ❑ No IN *If No, please apply for a business license with the Customer Service Dept. Will the business have food preparations? ❑ Yes ❑ No Will there be any cooking of foods? ❑ Yes ❑ No Will there be any deep fat frying? ❑ Yes ❑ No Will you have food disposal on site? ❑ Yes ❑ No Will there be sumps or floor drains in the facility? ❑ Yes ❑ No Will the business have any chemicals on site? ❑ Yes ❑ No 0.0 3og6 C �9 Phone 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 CITY OF Building Safety Department n XBURG City of Rexburg 1tGcl-W 35 North 1St East America's Family Community Rexburg, Idaho 83440 DISTRIBUTION LIST Please provide the names and emails of anyone who should be getting automated updates for this project: Review Notes Name: /'11t81 lVe ry'-1 5 U Name: / 4'' e__ 2 AnQ� 7�[ Name: Name: Name: Inspection Tickets Name: Name: Name: Name: Name: Email: +' lam• I L'' Email: (Z qro no r c J Email: Email: Email: Email: Email: Email: Email: Email: Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 Revised 10/2016