HomeMy WebLinkAboutAPPLICATION - 19-00354 - BYUI Hart Building - RemodelC IT Y OF
REXBURG
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Arneriias 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.
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 day.
o 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
Initials 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.
Initials
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.
o The above policies will be enforced to all, regardless if this information is passed on to them or not.
Initials
Applicant's Name (print): 410 SignatureDate:
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 10/2016
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
Initials
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.
Ao
If a building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the
occupants may be evicted.
Initials
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 day.
o 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
Initials 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.
Initials
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.
o The above policies will be enforced to all, regardless if this information is passed on to them or not.
Initials
Applicant's Name (print): 410 SignatureDate:
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 10/2016
,.
CI TY O F
REXBURG
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America's Family Comnnonty
BUILDING PERMIT FORM Z 1
Updated 10/2016
BUILDING APPLICATION
Commercial Remodel
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
For Office Use
Permit Number: Application Fee: ❑ $100
1. Property Owner
Name: Brigham Young University - Idaho
Address: 525 South Center Street City: Rexburg State: ID Zip Code: 83460
Phone: 208.496.2664 Email: johnsona(@byui.edu
2. Applicant
Name: Big -D Construction Corp. Role: (Owner, Tenant, Contractor, etc.) CM/GC
Address: 343 East 4th North Suite 112 City: Rexburg State: ID Zip Code: 83440
Phone: 208.709.9761 Email: andrewmolford cr big -d com
Contact/Rep. Name: Andrew Wolford
3. General Contractor
Under Idaho Building Code, a registered contractor must do the work for a Commercial Building.
Name: Big -D Construction Corp. Registration #: RCE -4751 Exp.: 12/28/2019
Address: 343 East 4th North Suite 112 City: Rexburg State: ID Zip Code: 83440
Phone: 208.709.9761 Email: and rewmolford(@ big-d.com
Contact/Rep. Name: Andrew Wolford Phone: 208.709.9761 Email: andrewmolfordObig-d.com
General 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.
4. Project Description
Address: 311 S. 1st W. , Rexburg, ID 83440
Description of Work:
Project Description:
• Total cost of project - materials and labor: $
• Check all 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.
• 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 1 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): Andrew Wolford Signature: Date: 61 03' I-1
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 oP Building Safety Department
REXBURG BUILDING PERMIT FORM 210 City of Rexburg
c>v Updated l0/2016 35 North 1St East
A,nerica3Family Community Rexburg, Idaho 83440
BUILDING APPLICATION
Commercial Mechanical
For Office Use
Permit Number: Mechanical Fees Paid ❑
1. Property Owner
Name: Brigham Young University - Idaho
Address: 525 South Center Street City: Rexburg State: ID Zip Code: 83460
Phone: 208.496.2664 Email: _ iohnsona(�byui.edu
2. Mechanical Contractor
Under Idaho Building Code, a registered contractor must do the work for a Commercial Building.
Business: Exp.:
Address: rPhS
State. Zip Code:
Phone:
Contact/Rep. Name: 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: 311 S. 1st W. , Rexburg, ID 83440
Description of work:
❑ Project Cost: $
• Fees for commercial projects are charged by cost.
0 First $10,000 = 2% + $60. From $10,000 to $100,000 =1 % + $260. Above $100,000 =.S% +$1,160. i.e. Work costing
$15,000 will be charged $260 for the first $10,000 and 1 % of the remaining $5,000 = $260 + $50 = $310 total fg�
• There will also be a plan review fee totaling 10% of the above 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.
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.rexburg.org Permit Technician - (208) 372.2341
C I TY OF
REXBURG
Americas Family C'Ot munily
BUILDING PERMIT FORM Z Z
Updated 10/2016
BUILDING APPLICATION
Commercial Electrical
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
For Office Use
Permit Number: Electrical Fees Paid ❑
1. Property Owner
Name: Brigham Young University - Idaho
Address: 525 South Center Street City: Rexburg State: ID Zip Code: 83460
Phone: 208.496.2664 Email: johnsonaga byui.edu
2. Electrical Contractor
Under Idaho Building Code, a registered contractor must do the work for a Commercial Building.
Business: State License #: Exp.:
Address: i State: Zip Code:
Phone: m
Contact/Rep. Name: Ph e: Email:
Electrical 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: 311 S. 1st W. , Rexburg, ID 83440
Description of work:
❑ Project Cost: $
• Fees for commercial projects are charged by cost.
o First $10,000 = 2% + $60. From $10,000 to $100,000 =1 % + $260. Above $100,000 =.5% +$1,160. i.e. Work costing
$15,000 will be charged $260 for the first $10,000 and 1 % of the remaining $5,000 = $260 + $50 = $310 total fee
• There will also be a plan review fee totaling 10% of the above fee.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that 1 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. 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 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):
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
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C I TY OF
_. _- ------------
RE"URG
—()�
America's Family Community
BUILDING PERMIT FORM Z 3
( Updated 10/2016
BUILDING APPLICATION
Commercial Plumbing
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
For Office Use
Permit Number: Plumbing Fees Paid ❑
1. Property Owner
Name: Brigham Young University - Idaho
Address: 525 South Center Street City: Rexburg State: ID Zip Code: 83460
Phone: 208.496.2664 Email: iohnsona( byui.edu
2. Plumbing Contractor
Under Idaho Building Code, a registered contractor must do the work for a Commercial Building.
Business: State License #: Exp.:
Address: CState: Zip Code:
Phone: Contact/Rep. Name: TpBa
Email:
Plumbing Contractor Authorized Signature: Date:
A copy ofyour state registrationflicense 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: 311 S. 1st W. , Rexburg, ID 83440
Description of work:
❑ Project Cost: $
• Fees for commercial projects are charged by cost.
o First $10,000 = 2% + $60. From $10,000 to $100,000 =1 % + $260. Above $100,000 =.5% +$1,160. i.e. Work costing
$15,000 will be charged $260 for the first $10,000 and 1 % of the remaining $5,000 = $260 + $50 = S310 total fe
• There will also be a plan review fee totaling 10% of the above 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.
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.rexburg.org Permit Technician - (208) 372.2341
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CITY O F
REXB, URG
Aniericas Fbmi! Community
BUILDING PERMIT FORM 401
Updated 10/2016
Building Safety Department
City of Rexburg
35 North 1St East
y Rexburg, Idaho 83440
BUILDING APPLICATION
Fire Alarm
For Office Use
Permit Number: Fire Alarm Fees Paid ❑
1. Property Owner
Name: Brigham Young University - Idaho
Address: 525 South Center Street City: Rexburg State: ID Zip Code: 83460
Phone: 208.496.2664 Email: Iohnsonaftyui.edu
2. Contractor
Business: State License #: Exp.:
Address: State: Zip Code:
Phone: TBD
Contact/Rep. Name: Email:
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,
3. Project Description
Address: 311 S. 1st W. , Rexburq, ID 83440
Description of work:
❑ Fire Alarm System Cost: $
• Fees for fire alarm systems are charge by cost:
o First$10,000 = 2% + $60. From $10,000 to $100,000 = 1% + $260. Above $100,000 =.5% +$1,160. i.e. Work costing
$15,000 will be charged $260 for the first $10,000 and 1 % of the remaining $5,000 = $260 + $50 = $310 total fee
• There will also be a plan review fee totaling 10% of the above 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
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):
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
y�
CITY OF
REXBIJRG BUILDING PERMIT FORM 4OZ
Updated 10/2016
CW
America's Family Community
BUILDING APPLICATION
Fire Sprinkler
Building Safety Department
City of Rexburg
3S North 1St East
Rexburg, Idaho 83440
For Office Use
Permit Number: Fire Sprinkler Fees Paid ❑
1. Property Owner
Name: Brigham Young University - Idaho
Address: 525 South Center Street City: Rexburg State: ID Zip Code: 83460
Phone: 208.496.2664 Email:johnsonaCa)byui.edu
2. Contractor
Business: Exp.:
Address: TPhfoEmail:
State: Zip Code:
Phone:
Contact/Rep. Name:
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: 311 S. 1st W. , Rexburg, ID 83440
Description of work:
Number of Heads:
❑ Fire Sprinkler System Cost: $
• Fees for fire alarm systems are charge by cost.
o First $10,000 = 2% + $60. From $10,000 to $100,000 =1 % + $260. Above $100,000 =.5% +$1,160. i.e. Work costing
$15,000 will be charged $260 for the first $10,000 and 1 % of the remaining $5,000 = $260 + $50 = $310 total fee
• There will also be a plan review fee totaling 10% of the above fee.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that 1 have read this application and state that the information herein
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):
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
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CITY OF
y REXBURG
Americas Family Community
SUBCONTRACTOR LIST
Excavation & Earthwork:
Concrete:
Masonry:
Roofing:
Insulation:
Drywall:
Painting:
Floor Coverings:
Plumbing:
Heating:
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses:
Floor/Ceiling Joists:
Siding/Exterior Trim:
Other:
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 Revised 10/2016
C IT Y OF
REXBURG
---- Oa.
America's Family Community
State of Idaho
County of Madison
I,
Name
Affidavit of Legal Interest
Address
City State
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, skip to B)
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
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
`F„k.x "�
CITY OF Building Safety Department
` 'rte
REXBURG City of Rexburg
— C --- 35 North 1St East
America'sFhmilyCommunity Rexburg, Idaho 83440
DISTRIBUTION LIST
Please provide the names and emails of anyone who should begetting automated updates for this project:
Review Notes
Name: Andrew Wolford
Name: Kenny Rasmussen
Name: Matt Blomquist
Name: Tyler Ames
Name: g12 -R-) E LAi7-SE#4
Inspection Tickets
Name: Andrew Wolford
Name: Kenny Rasmussen
Name: Matt Blomquist
Name: Tyler Ames
Name:
Email:
and rewmolford(g)big-d com
Email:
krasmussenCa biq-d.com
Email:
matt.blom uist bi -d.com
Email:
tyler.amesObig-d com
Email: 1.-��Sj I T C I o Iff.Dj
Email: and rew.wolfordCEDbig-d com
Email: krasmussenC@big-d.com
Email: matt. blomguist biq-d.com
Email: _ tyler.ames@big-d.com
Email:
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 Revised 10/2016
is CITY OF
REXBURG
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? Aes ❑ No
Will the business be doing any structural/or remodeling changes to the building? Yes ❑ No
Any changes to the electrical? Aes ❑ No
Any changes to the plumbing? ❑ Yes GeNo
Any changes to the mechanical system? Aes ❑ No
Is the business type changing? ❑ Yes, it will change to
Is this business changing ownership?
Is the business registered with the City of Rexburg? BeYes, License #:
*If No, please apply for a business license with the Customer Service Dept.
Will the business have food preparations?
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?
Applicants Signature
Phone
Date
AO
❑ Yes i1No
❑ No
❑ Yes BrNo
❑ Yes 910
❑ Yes IIeNo
❑ Yes IeNo
❑ Yes 40
B yes ❑ No
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