The URL can be used to link to this page

Home My WebLink AboutAPPLICATION, PLANS - M19-00102 - 4024 Molly Dr - Basement FinishMadison County Pre -Construction Check List and Required Fees PLAN AHEAD — The following items must be completed, as outlined below, before you submit your building permit application. BE AWARE that it may take 3-5 working days to review and approve your plans, even if you have all the required information. Incomplete applications will delay the issuance of a permit. Building Permit Fee Deposit is due upon application submittal BUILDING PERMIT APPLICATION Building Permit No: - — — - — Issue Date: _By: 1. Owner: J OUrCA 6 04 +9- r- 2. Property Address: 3. Parcel Number: 4. Subdivision Name: A —Block:_ Im 5. Owner Phone Information: 6. Owner Mailing Address:, q02-4 1-4,0t �j Dy :W),b , -c 7. Contractor. ,\e 8. Contractor Mailing Address:_____ 9. Contractor Phone Number: 10. Contractor License No: Expiration Date: 11. Owner/Contractor Email Address: iareA `bb \4+-- r YnCkk* V.-Cofn 12. Proposed Use of permit: (Single family home, garage, basement, shed, shop, commercial, pole building, lean-to, religious, government, schools, agriculture building, fence, deck, carports, patio, greenhouse, sun room, other.) C, 13. Surfaces: (shall include the exterior wall measurements of the building) Residential: Finished Basement: Bonus Room Closed Shop: �s Commercial: Other (specify): 14. Flood Plain: Garage:__ — _ITnfinished Basement: _ Are you in a floodplain? If yes, which zone are you in? Addition: Open Shop/Shed: AG Building: __ 'des No x X– - _m�O 15. Flood Plain Permit #: If you desire to build in a flood zone you must get a Flood Elevation Certificate from the Flood Plain Administrator, have your land surveyed to determine the flood elevation, submit the completed certificate, signed by the surveyor. A hearing will then be scheduled with the Madison County Board of Commissioners to get their approval and signatures on the certificate. Once that process it completed and you have the Board's approval, you will be given a building permit. Applicant's signature, certification and authorization: I hereby certify that I have read this application and state that the information herein is correct. I agree to comply with all County regulations and State laws relating to the subject matter of this application and hereby authorize representative of Madison County to enter upon the above-mentioned property for inspection purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 24139 International Codes in case of any false statements or misrepresentation of fact in the application on which the permit or approval was based. Signature of owner/contractor Building Department Date _J4 4 L� �oz �/ - — Date 2 �tEXB(t� CITY OF �^ REG 3 O Amer' 's F r '1 • C Building Safety Department City of Rexburg 35 North 1St East tca ar u} orrrrrmrut} 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. Please fill out this form showing your exemption and send 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 knowledge. S' re Print Name Ll Date Permit Technician - (2 08) 372.2341 www.rexburg.org Revised 10/2016 LU s cl w F Ep�gWg�v@�� @"'�@5 8avm lu t gY'9No°g?a°&,8$ E' �b°n�N�mo�m v', E<`sw g58.�$N.`2 w`° °mg�3 Fngo - 4—j aauapisaa JOIA0e � O N Ln I yak§& s E. 2 83WTOH am ` I O O g $ `• a NmY z z 3 °ga I BFB w z��S w° o 4jbj u A ii i 088Z-bZS 3JDPPo7S 'W'1 3agjulp 3 a <�« a31sap z nnn NLLLLLL�LL $ ��5��€ WBS o5m-$w$�8g SAM aauupuns qTm of 0 p g 4—j i � O I yak§& E. 2 1 am 0=1 I � g $ .LE4a a NmY 'O` m G I WWi'- nnn NLLLLLL�LL $ ��5��€ WBS o5m-$w$�8g SAM a qTm of 0 p g I 8992 Ni Z �0 C W ��omE°mo i .FR_,_$ €t 5`"� 3I ; _ E 3a U a oaa eccecz N e a �$ .o8m `—°aF ma`5�gfi €m og°�aamalaz �g<< v°�'$maa$� n I o I I I I s9z I m I I I 1...1 a� F Oro .1 l a„s�o vl•; o ' I.: VIII ee�N a ml : l $ I mo o Ir r— I- I o 99az I L -- L-------='�°�- Ij 1 -L r---- oo I I - I L_L i____� .• I I I I: E 99 az s`°g I I I [[ I 'o 1 OI i i w 4 -ccz. I SI S 2o. O=ff I I op Q - I °� o�Q I 1 uuM a,n,ea°2 I I I I I I w 1'I 1 I 1 L ------------------------------------------J 4—j O<< O yak§& E. 2 1 am � g $ .LE4a a NmY O WWi'- nnn NLLLLLL�LL $ ��5��€ WBS o5m-$w$�8g SAM a qTm N > 00 Ni Z �0 C W ��omE°mo i .FR_,_$ €t 5`"� 3I ; _ E 3a U a oaa eccecz N e a �$ .o8m `—°aF ma`5�gfi €m og°�aamalaz �g<< v°�'$maa$� n 8 >E"a5 4—j LU s cl w F Ep�gW�v@�� @"'�@5 8avm lu t g>u90°g?a°E' �b°n�N�m°�m v', E<`sw g58.�$N.`2 w`° °mg�3 Fngo - a- 3:2 O O U- m m 01 eo t7 r) 19 aaueplsaa JOIA0e � N Ln I �' s 83WTOH ` O O gam `• ° $ z z g °ga a0 _ a z��S w° o y 4jbj it A it i 088Z-bZS 3JDPPo7S 3agjulp 3 a <�« a31sap z WWi'- ,b, Ul€ aauupuns �yyTm NLLLLLL�LL $ r) 19 I � I I �' I I I eosz � 4 IIa I E gam ° $ I a0 _ a I roO ga�eD°E�`g WWi'- ,b, Ul€ �yyTm NLLLLLL�LL $ 61 O M om a m9� 9E9n °B ^g $fr daacyoffioa�m.�' 5 3 §$°'s I Z m I o I c l •. I° 3m➢ro _�E U a oaa eccecz N e a �$ .08, `—°aF m�S�gfi €m o P1 S g S s g8 n I I I III I ",a°� eaoaea�%d c -)m � of , " U I l rL I g I = O m [[ o L — — — — — — —IHy r -L r----� LQJ I .g� Puu I •-Ti I I1 J I I L_L i____� I I I I 'o I �I j l J I �s2 I I` I ¢° gogg °off¢ o�Q I I — •�I �g y°3 I I I I I I w I'I I I L ------------------------------------------J r) 19 E gam ° $ a0 _ a a NmY roO ga�eD°E�`g WWi'- ,b, Ul€ �yyTm NLLLLLL�LL $ 61 o5m-�8g SAM om a m9� 9E9n °B ^g $fr daacyoffioa�m.�' 5 3 §$°'s Z P�4�B CCU `a c ¢B�m E°a5 . dE ysm"Paamo� `�' -$ 3m➢ro _�E U a oaa eccecz N e a �$ .08, `—°aF m�S�gfi €m o P1 S g S s g8 n r) 19 LU s Cl w F Ep�gWg�v@�� @"'�@5 8avm lu t gY'9No°g?a°&,8$ E' �b°n�N�m°�m v', §<`sw g58.�$N.`2 w`s °mg�3 Fngo - a 3:2 O O LL m m of eo t7 aauapisaa aaj/Coe � N Ln I I: s Yn 83WTOH ` I O O gam $ `• ' o m eeaz z z g °ga I z��S w° o O 4jbj u A ii i 088Z-bZS 3JDPPo7S 3agjulp 3 a <�« a31sap z WWi'- eD°El,b, aauupuns o f nnn o p� g i � I I: Yn Y o� I E gam $ .L E4a ' o m eeaz 'O` m I n NmY O WWi'- eD°El,b, o f nnn o p� g I 8992 o5m-$w$�8g a •. l > 00 $8$$..� v&E9n °B daacyoffioa�m.�' 3 §$°'s ��. m m o� I Mc `a c ¢B�m E°. a5 ¢�• i A L _�E I o I I I - I I I l...l Oro I. _- III � a ��,„. I vol•; ' I.: VIII �o eeN a ml : l a l mIr o r— I- I o 99az -L r---- � I .•; I I I - li I L -L i----� .• 1 I I I: E 9s az s`°g I I I� 'o I p �s2 I SI 'z S o=¢ °oF I I o og I o�Q I Jg yo3 I 1------------------ @w° uuM a,n,eao2 I I I l I I w I'I lL------------------------------------------- I I E gam $ .L E4a g m m n NmY O WWi'- eD°El,b, nnn NLLLLLL�LL $ ��5��€ WBS o5m-$w$�8g a qTm N > 00 $8$$..� v&E9n °B daacyoffioa�m.�' 3 §$°'s z Mc `a c ¢B�m E°. a5 ysm"Paamo� `�' 3m➢ro _�E LU s Cl w F Ep�gW�v@�� @"'�@5 8avm IU t g>u90°g?a°E' �b°n�N�m°�m v', E<`sw g58.�$N.`2 w`° °mg�3 Fngo - LU aaueplsaa JOIA0e O<< O N Ln yak§& l �' s I I I e99z 'ty 83MTI OH ` O O I` gam `• v 0 -as j z z 3 °ga BFB w z��S w° o y 4jbj it A it i 088Z-bZS 3JDPPo7S 'W'1 3agjulp 3 a <�« a31sap z nnn NLLLLLL�LL $ 61 o5m-$w$�8g aauupuns N > 00 LU O<< O yak§& l �' I I I e99z 'ty 7 I ° $ I` gam a 4 v 0 -as j roO ga�eD°E�`g WWi'- Ob` I �yyTm nnn NLLLLLL�LL $ 61 o5m-$w$�8g a N > 00 09E9n °B daacyoffioa�m.�' 3 §$°'s ¢B�m E°. a5 ysm"Paamo� `�' 3m➢ro _�E U eccecz a ii `—°aF m�S�gfi frmo"aama�t.g<< $maa S g S s g� @°=.�F@m E@m2�C $� 3�.°� � •:" o" I I n m� �, F O e I I I �,is°� " all m c-) al , U I l 1111 l eaoaeas;%d � F'�, I m [[ o E -i r----� i----� L_i v � I I. Q -z. I I I ;I ° o I I ..I �g r �o J ueM e°n,eao2 I I I I I w l'I I l L------------------------------------------- LU O<< O yak§& E ° $ gam a0 _ a a NmY roO ga�eD°E�`g WWi'- ,b, U'l€ �yyTm nnn NLLLLLL�LL $ 61 o5m-$w$�8g a N > 00 09E9n °B daacyoffioa�m.�' 3 §$°'s ¢B�m E°. a5 ysm"Paamo� `�' 3m➢ro _�E U eccecz a ii `—°aF m�S�gfi frmo"aama�t.g<< $maa S g S s g� @°=.�F@m E@m2�C $� 3�.°� � LU