HomeMy WebLinkAboutAPPLICATION - 19-00364 - East Idaho Credit Union - New BuildingUR0
C I TY OF
REXBURG
Americas 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? /Yes ❑ No
Will the business be doing any structural/or remodeling changes to the building? ❑ Yes d No
Any changes to the electrical?
❑ Yes H No
Any changes to the plumbing?
❑ Yes V No
Any changes to the mechanical system?
❑ Yes of No
Is the business type Yes, it
changing? ❑ will change to
d No
Is this business changing ownership?
❑ Yes �No
Is the business registered with the City of Rexburg? ❑ Yes, License #: ' -- R ❑ No
*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 I(NO
Will there be any deep fat frying? ❑ Yes I/No
Will you have food disposal on site? ❑ Yes V/No
Will there be sumps or floor drains in the facility? ❑ Yes d
Will the business have any chemicals on site? ❑ Yes No
�'z^ 7.O f - 3/3
Applicants Signature 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
C I TY OF
REXBURG
America's Family Canmunity
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 Date
Printed Name
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 Revised 10/2016
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C IT Y OF
REXBURG
America's Family Community
BUILDING PERMIT FORM 2 0
Updated 03(2017
BUILDING APPLICATION
New Commercial Building
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
For � illi,_f. Usti p d
Permit Number: 1 'QQ 3i0� Zoning: C8(1 (1 Application Fee: ❑ $1000/Building
Name: East Idaho Credit Union
Address: 865 S. Woodruff Ave. city: Idaho Falls State: I D Zip Code: 83401
Phone: 208-535-3893 Email: ccard;Tve—ll@eastidahocu.org
r°l1' lit; 111
Name: SCC Construction Role: (Owner, Tenant, Contractor, etc.) Contractor
Address: 5151 W 5000 N city: Rexburg State: ID Zip Code: 83440
Phone: 208-313-4963 Email:
Contact/Rep. Name: Shane Webb wnctl 01►^
Under Idaho Building Code, a registered contractor must do the work for, Co erc'aI Building,
Name: SCC Construction Registration 9. Exp.: 101m
Address: 5151 W 5000 N City: Rexburg State: ID Zip Code: 83440
Phone: 208-313-4963 Email:
Contact/Rep. Name: Shane Webb Phone: 208-31 3-4963Email: sccestimateslDagmail.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. if you are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
ion
• Address: 310 North 2nd Street -OR- Lot #: Block #: Subdivision:
• Project Name: EICU New Rexburg Branch • Construction Type: Vb • Occupancy Type: B _
• Square footage: 2,581 • Total cost of project - materials and labor: $
• Check all disciplines that apply: M Mechanical: Cost $ M 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: 1 0 Water Meter Size(s): 0 # of Parking Stalls: 31
• # of Dumpsters: 1 • Estimated Dumpster Delivery • # of Dumpster Pickups/week
Date: / / Q 2 3 4 5
• Other Comments (if any):
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 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. 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
CITY OF
REXBURG
CW
Anu lu s gantry Cammwrhy
Affidavit of Legal Interest
State of Idaho
County of Madison
Name e Address
City
Being first duly sworn upon oath, depose and say:
(if Applicant is also Owner of Record, skip to B)
State
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:
5 WQ N� P A bfA rtj ID 834q b
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 f l tday of c.1 l+ tje 20 101
Signature
Subscribed and sworn to before me the day and year first above written.
Notary Public of Idaho
LH+ M S. strum Residing at:
NOTARY PUBLIC - STATE OF II"
c�OMMIssl NUMO tGIM My commission expires: 5117 la oa 5�
MY COMMISSION WIRES 5-17 2M
inspection Hotline - (2W 372.2344 www.rexhurgorg Permit Technician - (208) 372.2341 Revised 10, 2016