HomeMy WebLinkAboutAPPLICATIONS, CO, MULT DOCS - 12-00201 & 12-00202 - 374 E 4th N - Dr Andy Summers OrthodonticsCiTY OF Gertificate of Occupancy
City of Rexburg
Department of Community Development
35 N. 1st E. / Rexburg, lD. 83440
Phone (208) 359€O2O lFax (208) 359-3022
Building Permit No:
Applicable Edition of Gode:
Site Address:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
Name and Address of Owner:
Contractor:
Special Conditions:
12 00201
International Building Code 2009
374E.4th N.
Dr. Andy Summers Orthodontics
Type V, non-rated
32
No
Summers Andrew W Etux
447S 3E
Rexburg, lD 83440
Brett Jensen Construction
Occupancy:Business - office, professional or service transactions
This Certificate, issued pursuant to the requiremenfs of Section 109 of the lnternational Building
Code, certifies that, at the time of issuance, this building or that portion of the building that was
inspected on the date 4isted was found to be in compliance with the requirements of the code for
the group and division of occupancy and the use for which the proposed occupancy was
classified.
*/te/tsDate C.O. lssued:
C.O lssued by:
There shall be no further change in the existing occupancy classification of the building nor shall any structural changes,
modifications or additions be made to the building or any portion thereof untilthe Building Official has reviewed and
approved said future changes.
Building Official
CII'Y OF
REXBURG(\'--- ..--'
'1 we rico\ l:ami Iy ( )ornnnn ity
Gertificate of Occupancy
City of Rexburg
Department of Community Development
35 N. 1st E. / Rexburg, lD. g3440
Building Permit No:
Applicable Edition of Gode:
Site Address:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
Name and Address of Owner:
Contractor:
Special Conditiohs:
Occupancy:
12 00201
lnternational Building Code 2009
377 Walker Dr
Dr. Andy Summers Orthodontics
Type V, non-rated
32
No TEMPORARV
)L(Y [1,'
Summers Andrew W Etux
447S 3E
Rexburg, lD 83440
Brett Jensen Construction
Temporary certificate of occupancy until handrails are installedon the back steps. Expires January 31,2013.
Business - office, professional or service transactions
This Certificafe, issued pursuant to the requiremenfs of Sec tion 1 0g of the lnternationat BuildingCode, certifies that, at the time of issuance, this buitding or that portion of the bui66g that wasinspected on the date listed was found to be in compliince with the requirements of the code forthe group and division of occupancy and the use for which the proposrd o""rp"ncy wasclassified.
C.O lssued by:
There shall be no further change in the existing occupancy classification of the building nor shall any structural changes,modifications or additions be made to the build-ing or any fortion thereof untir ne auiio]nfomciat has reviewed andapproved said future changes.
Plumbing Inspector:.Fire Inspector:
Electrical Inspector:P&Z Administratoi
ffiertlfieate of Oceupancy
City of Rexburg
Department of Community Development
35 N. 1st E. / Rexburg, lD. 93440
lFax 3s9-3022
Building Permit No:
Applicable Edition of Code:
Site Address:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
Name and Address of Owner:
Contractor:
Special Conditiohs:
Occupancy:
Date C.O. lssued:
12 00201
International Building Code 2009
327 Walker Dr
Dr. Andy Summers Orthodontics
Type V, non-rated
32
No TEMPORARY
Summers Andrew W Etux
4475 3E
Rexburg, lD 83440
Brett Jensen Construction
Temporary certificate of occupancy until handrails are installedon the back steps. Expires January 31,2013.
Business - office, professional or service transactions
This Certificate, issued pursuant to the requirements of Section 10g of the lnternationat BuildingCode, certifies that, at the time of issuance, this buitding or that portion of the bui66g that wasinspected on the date listed was found to be in comptiahce with the requirements of the code forthe group and division of occupancy and the use for which the proposed occupancy wasclassified.
/////2/tz/tz
a--
Plumbing Inspector:
Electrical Inspector:
There shall be no further change in the existing occupancy classification of the building nor shall any structural changes,modifications or additions be made to the building or any portion thereof until the Building official has reviewed andapproved said future changes.
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CI'tY "rtREXIsURG(\[,
A ne r ic n's [itn i Iy Co m m u n i ty
COMMERCIAL & MULT'I FAIVIILY BUILDING PERMIT AIDPLICATION
35 N 1" E, REXBURG, ID 83440
208-372-2326
PARCEL NUMBER: (We will ptovide this for you)
SUBDIVISION:UNIT# BLOCK# LOT#
OWNER N'4tu18: A{p?gr"-) 3on^$ql' CONTACT PHONE #?o6 - n43b
PROPERTY ADDRESS:
PHONE #: Home ( )--- Work ( )- Cell ( ) 7O5 - D?3O
OINER MAILING ADDRESS .3 b?E*'*'N'NfIW, %Ag^ SrTP.: IO ZIP: 694
nwrlr., ptx &'5745
APPLIUIIT (If other than owner)
(Applicant if other than owner, a statement authorizing applicant to act as agent for ownet must accomPafly this application.)
APPLICANT INFoRMATION: ADDRESS llf]7 @ottr> N€ CtW: h6ou
STATE; t Ar,to ZlPS?#b- EMAII r,ao'tnO jr,la.crqrFAx O6\ ?A-Z?V I
PHONE #: Home ( )- Work rft) 361' Z7a cen ( )
CONTRACTOR:
MAILING ADDRESS:crTY____________ST ATE ____:ZrP
PHONE: Cell#Work#Fax#
EMAIL IDAHO REGISTRATION # & EXP. DATE
How many buildings ate located on this property?
inE is based on the information must be
t ltr;rllf
Did you recently purchase this propettyl No @f yes,list previous ownef's name)+tr*rs o.l
Is this a lot split? NO
PROPOSED USE:
(i.e., Single Family Residence, Multi Family, Apartrnents, Remodel, Gatage,Commercial, Addition, Etc) - CIRCLE ONE
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: underpanatyof pejury,Ihercbycerti$*ratl
have read this application md state that the infomation hercin is conect and I sweat that any information which may hereafter be givcn by me in heamgs- before the
plming and Zoning Comission ot the City Comcil for the City of Rexbug shall be mrtMul and corect. I agree to comply with all City rcgulations md State lrus telating
to t1" sibl*t -"tter"of this application md here\ authotized representatives of the Gty to enter upon the above-mentioned property for hspections purposes. NOTE:
The building official may revofe a permit on approval issued under the provisions of the 2003 Intemational Code in cases of any false statement or misrePrcssrtation of frct
in the application ot which the permit or apptoval was based. Pemit void if not started within 180 days. Pemit void if work stops for 180 days'
4r7ol4otZ
DATE
Do you prefer to be contacted by fax, email or Phone? Circle One
WARNING - BUIIDING PERMIT MUST BE POSTED ON CONSTRUCTION STTEI
Plm fece re non-tefrind.blc sd {€ paid in ftIl at thc time of applicerion bcdfrnlaglttgtg,J,M
City of R€xbug's Acceptme of dre plo rcviry fce doee nol cotrstitute pLn aPProvd
rrBuitding Pemit Fees ale due et time of application** r*Building Pemite re void if you chcck dca not deartr
r/Applicant
description of property)
-IY OF
REXBURG
www.rexburg.org
(16)
A rte rk a's Fa ni Iy ('lvn rnwt i ty
Address
I-or^ 1,
Being first duly sworn upon oath, depose and say:
(IfApplicant is also Owner of Record, skip to B)
That I am the record owner of the property described on the attached,and I grant mypermission to: _
to submit the accompanying application pertaining to rhat propety.
B' I agree to indemni$', defend and hold Rexburg City and its employees harmless from anyclaim or liability resulting from any dispute "r Io thl statements conained herin or as to theownership of the pfoperry which is the subject of the application.
Dated this 2t4 a^y or t4 Pn.' / ,20-!z
subscribed and sworn to before me the day and year first above written.
Noary Public of Idaho
Residing at:
Building Sofety Depqrlmenl
City of Rexburg
Phone:208.372.2326
Fox: 208.359.3022
Affidavit of Legal fnterest
State of Idaho
County of Madison
'l r a-)
l, trl d.<"u 5 u-aa€ r5
Name
/)/./ I1J\?xb.nrq ,Ciw (
My commission expires:
Building Sofety Depqrlmenl
City of Rexburg
Phone:208.372.2326
Fox:208.359.3022wwwrexburg.org
Property lines
Each site plan that is submitted to the city of Rexburg for the Building Permit process requires that property lines
are shown accutately' It is the Developer's responsibility to coffectly identify on the site plan the location of these
lines in reference to the public righrof-way, other adjoining property lines, the street, other structures and all utility
lines' The Developer should find property pins that are s.ill available at the lot in question. If these pins do not
exist or have become unrecognizabie 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 identiS' property line location is with alandsurvey. 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 accutacy. If you want to request a copy of your lot, see the front counter at the Community
Development D epartment.
I have read and undersand the above requirements.
4-7a-htz
Date
cttY oF
REXBURG-- c\l
Amtri.a\ ftrmiIy Oonnnwity
Builng Sofety Dep.T,T:F
l.t E., Rexburg,Id,83440 CitY
- (208)359-3020 / HotJtne - Q08)372-2344 / Fax - (208\359_3022
OV/NER'S NAME
PROPE,RTY ADDRESS 1-/q E . 4IfrM
SUBDIVISION
PI{ASE
35 N.
Phone
cll'Y oF
REXBURG
c\' -'.---
Am e rica\ Fami ly Communi ty
Permit# ru A02Ol
LOT.--- BLOCK Approved for temporary power
Approved for permanent power
n
A
(COMMERCIAL/IND_USTRIAL) Total cost of electdcal system (Conftacted Amount) $$2U , 1100
(nckdes tbe mst of materials iystalled regardlex of the parE suppling it. Tbefees lisnd uider thh ispution 4,p, ,t "tt ojpj; ;r;;im/not specifcal! mentioned elsewbere on tlt*fonz).
! Up to $10,000 (total cost of system x 0.02) + 60 = $tr Between$10,001-$100,000 ((totalcostof s]rstem_10.b00)x0.01) + g260 =$ 4Z,lD over 9100,001 ( (total cost of system - 100-00b) x o.obs) i gt,teo = g
Small Wotks (Conftactots oNLY): $10 fee for wotk not exceeding $200 in-.osi "nd not involving a change in
service connections. Does NOT require inspection.
RESIDENTIAL
New: Single Family Dwelling, including aII buildings with widng being constructed on each propetty. (*Based on liuing space,see definition below)
Requircd!!!ELECTRICAL
Fax (
D Up to 1,500 sq ft - 9130
D 2,501. to 3,500 sq ft - 9260
n Over 4,500 sq ft 9325 plus 965 for each additional 1,000 sq
1-000 sq. ft. or portion thereo0).
New: Multi-Family Dwelling (Contractors OnIy)
! Duplex Apartment 9260
! Three or more multi-family units: g130 per building plus $65 per unit:T
r''-----r.-"Y^"r!
F::*::.:t:p_ j:lT,]l1|ij* "f Fj_.._"'1..p::!:g sq. ft. of the building (g65 + ($1d x # branch ctucuits)! Central Heating/Cooling Systems: $65 when NoT p"rt of new residentii "t rrvAc p..-it *itt, to "aditionalWi"irg
Spas, Frot Tubs, and Swimming pools: $65 fee for each trip to inspect
Pumps-lYate4 ftrigation, Sewage (each motot)
! $65 up to 25HP r$95 - 26 to 200Hp r$130 over 200 Hp
MISCELI-ANEOUS
tr Temporaty Construction Services ONLY: 200 amp or less, one location (for a period not to exceed 1 year) - $65! Temporary Arnusemenc $65 fee plus $10 per ride, concession or generator
! Irrigation Machine: $65 for center pivot plus $10 per tower of drive motor
tr Technical Service: $65 perhour
n Plan Check 965 per hour
! Requested Inspection: 965xliving Space - space within a dwelling unit intended for human habitation which may reasonably be u 'lized for sleeping, eating, cooking,bathing, *?**, recreation, and sanitation pu{poses. An unfinished basement is considered pai of the living space.
dTSf) ,-.si -rs e_/q-eo:^v.tg"aue or ucensed Lo License number & exp. date Date
D 1,501 to 2,500 sq ft - 9195
n 3,501 to 4,500 sq ft - fi325
ft. or portion thereof (9325 + ($65 x # of additional
ONTNER'S NAN,{E,
PROPERTY ADDRESS
Building Sofety Depqrlment
City of Rexburg
LOT_ BLOCK
OF
35 N. 1$ E., Rexburg, Id 83440
SUBDIVISION
PHASE
REXBURG
cllJ *-'. -__,
Ame rical Family Co mmunity
Reqatued!!!
Mechanical Contractor's Name
Address
Cell Phone (Business Phone (
Fax (
tt:XY,::?:*!:::X:T:*),::i"T:,:l'.rgre;h1ni3ar,'v:l:- (con,ractedAmoun,) $ tn 910a,, a, i i * n,p,;;; ;;;, h " /,',;; ;;ir:;;i;, *;in.rtal/ainnr nnt thpiirnlln, nooi^-.) .t"-.^,L--^ ^"- aL:^ t-.-,,,1installations not tpecifca@ mentioned eLreahere on tUi1ornl.
! Up to $10,000 (total cost of system x 0.02) + 60 = $D Between $10,001 - $1001000 ( (total cost of system _ 10.600,r x 0.01) +n Over 9100,001
RESIDENTIAL
( (total cost ofsystem- 100.000) x 0.005)
$260 = $
+ $1,160 = $
r{ew: single Family Dwelling, including aII buildings with widng being constracted on each ptopetty. (*Based on Euing space,see definition below)
tr Up to 1,500 sq ft - 9130 ! 1,501 to 2,500 sq ft _ g195tr 2,501. to 3,500 sq ft _ 9260 ! 3,501 to 4,500 sq ft _ g325tr over 4,500 sq ft $325 plus $65 for each additional 1,000 sq fr. or portion rhereof
New: Mutti-FamilyDwelling (contactots83;-
($65 x I
u Duplex Apartment 9260
tr
!
Three or more multi-family units: $130 per building plus g65 per unit:
License number & Exp. date
T
**HVAC equipment beinginstalled up to the maximum of the co'es;;;d;il:;J;:;hdh;
MISCELLANEOUS
($65 + ($10 x # of fixrures)
D Plan Check 965 perhour
tr Technical Service: 965 per hour
! Gas Line: 965
D Water Heater Replacemenc $65
u Requested Inspection: $65
tr Fireplace/Solid Fuel Burning Appliance: g65 per inspection
xliving Space - space within a dwelling unit intended for human habitarion whigh may. leasonably b-e gtilized for sleeping eating, cooking,
i:**:::Y*'^XTji:TITI]f1" n",+"'es. An ""n"irr'.a u"rement is considered part orthe living space.*xExamples of FWAC Equipment-fumac. repli.ement, solar, water heater, etc.
ek Iqb lzTt,r.t;-*
Date
city srae Zip.
tute of Licensed Conttactor
35 N. 1,t E., Rexburg, Id 93440
OWNE,R'S NAME
PROPERTY ADDRESS
Building Sofety Depqrlment
City of Rexburg
Permit#
******+*****x*Vatet Metet Size:
C]TY OF
REXBURG
c\'-- -'-
Ame ricab Family Commuil ity
Water Metet Quantity:
Requircd!!!
Plumbing Conttactot's Name
Address
Plumbing
1,,. l^ f [(r+tl(4-tr Yusnffie
State Zip
(COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (conttactedAmount) $-
f::?::;;::,;';I#::';;1tr:i:i;t;ffi;ofihepart: suppltingit. -rrt,1eu
li:teiunde*hit inspection lpe shall app[, to aryt and a//plumbinsinstallationr
Fax (
D Up to $10,000 (total cost ofsystem x 0.02) + 60 = $
: R::"j1gllfol - $100,000 f ftnta l*1"S,,._ _rb.6ool x 0.01) + g260 = g! Over 9100,001 x 0.005) + $1,160 = gRESIDENTIAL
New: single Family Dwelling, inctuding aII buildings with wiring being consttucted on each ptoperty. (*Based on liuing space,see defrnition below)
Cell Phone ( ) gusiness phone (
Sewet & Water
! 938 Sewer Line a$38 Water Line
! Up to 1,500 sq ft - 9130tr 2,50't. to 3,500 sq ft _ 9260D Over 4,500 sq ft 9325 plus g65 for each additional 1,000 sq
- - _ 1_.O00 sq. ft. or oortion thereog).New: Multi-Family Dwelling (Con tactoii Ontyl
! Duplex Aparment 9260
tr 1,501 to 2,500 sq ft _ g195
3,501 to 4,500 sq ft - $:ZSft. or portion thereof ($325 * ($OS x # of additional
: l}::,::Xtemulti-family-units: g130 per building plus g65 per unit:T
sq. ft.of thebuilding ($65 + ($10 x # of frxtures))
Gtay Water Systems: gl30
tr Lawn Sprinklers/Backflow Device: $65D Modular, Manufactuted or Mobile Fromes: $65 for sewer and vrater stub connectionstr
ftftilu+ose Fire Sprinklet and Domestic water Supply system: g65 fee o, g+ p., sprinkler head, whicheverls gfeatef
D $65 Sewer tumaround under house (change
MISCELI.ANEOUS
tr Plan Check 965 per hour
! Technical Service: $65 perhour
D Gas Line: 965
D Water Fleater Replacement $65
tr Requested Inspection: g65
ng65 Sewer & Water_ if inspected at the same timefrom septic to ciry)
D Hydronic Heating: $65 + ($10 x # of manifolds/zones)*Living space - space within a dwelling unit intended for human habitation whigh may.lasonably b^e.utilizld for sleeping, eating, cooking,bathing' washing, recreation, and sanitalon pu{poses. An unfinished basement is considered part of the living space.
11(r*>httv,) I| .t | .t I
License number & Exp. dateature of Licensed Conftactor Date
guildingSofeV De
35N l"E
D$410
oortment'cw of Rexburg
^"::;:'fr':::*'*
FSXBURC
Arrleriia's Ftntill ('r./lflntuttttY
Yout Buitding/Home Q
UmodeliAg ruut vF-
*--F-*-- --^6rc.,f thebuitding)
<Fg
--
- -'-
s u RFA, E s Q,ARE F oorAGE :*;:
:*:
-;Y:::>
u"f*'o:9:::?iij.,Tfi-
2?o4 aafi iiJtt'"a basernent ^re^ -
FirstFloor Lt:.";:=^
?fr,dt'w
I
Vatet Meter QuantitY: -----,*-*
Address Business Phone: (
contactPhone:( \4F^*-
Email
Dishwasher
Floot Drain
Sinks-p".rt lJ.., kitchens' bar' moP)
plumbingEstimate $ (commercial only)
SPdnklers
Tub/Showets--
Toitet/Urinal
\(/ater Heater
Vatet Softenet
----
Clothes \(ashing Machine
Regrured/ srg""rr@
attot, nu/lDt h
-
Buifding Sofety Depqrlmenl
Cily of Rexburg
Phone: 208.372.2326
Fox:208.359.3022www.rexburg.org
CIIY OIJ
REXBURG'.(\,'
A nc r ieris fift ni\r ( :o nvil u n i ty
gJrll'Iry*u
PROPERTYADDRESS
SUBDIVISION Permit#
PIJASF rr rlroL r-OT--_._- BLOCK
Requircdlll MECI{'4AIIC'4L
Mechanical Contractor's Name: T AD _Business Name:
Address- ci*.ttl State zip
contact Phone: ( ) nusiness phone: (\_
Email ''-Ia
Mechanical Estimate $- (commetcial/Multi Family onry)
FrxruREs & APPLTANCES coaNT piagte Faaily Dwelliag oaly)Furnace Exhaust or Vent Ducts
Furnace/Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
Date
Unit Heater
Space Heater
Decorative gas-fired appliance
Incinerator System
Boiler
Pool Heater
Fuel Gas Pipe outlets including stubbed in or future outlets
Inlet Pressure (A{eter Supply) pSI
Heat (Circle dl that apply) Gas Oil Coal Fireplace Electric Hydronic
Required! Signature of Licensed Contractor License number
35N IJf E
Rexburg, D83440 www.rexburg.org
Building Sofety Deporlmenl
City of Rexburg
Phone:208.372.2326
Fox:208.359.3022
Permit#
REXBURG
c\,
tlmeicui limily Comnunity
OVAIER'S NAME
PROPERTY ADDRESS
SUBDIVISION
PHASE
Requircdlll ELECTRIC.AL
Electrical Contracror's Name t RD gusiness Name
Address City_ State Zip.
Cell Phone ( ) Business phone ( )
Fax ( ) Bmail -
ElectricalEstimate(costofwiring&labot)$-(CoMMERcIALoNL9
(Irchdet tbe cost of nanriab irxalbd ngadba of tbe pa4t ,lppbrnC it).
TTPES OF INSTALLATION
(Ncw Rcsidcatiel iacladcs c*eryrtiag coaaiacd withia thc tesidcathl cfritcdttE .ad *achcd gangc at thc semc tiac)
RESIDENTIAL ONLYtr i9P t" 1,500 sq ft - $72 tr *1,501 to 2,500 sq ft - g120tr *2,,!01 to ]500 sq ft - 9168 tr *:,SOt to +,SOO sq fi _ gnetr lovgr 4500sq ft - 9216 plus g.04lsq ft: sq ft totaltr Existing Residential (# of Branch Circuits) _ $a0 phs gf 0 per circuir # of circuitstr Multi-Family only: # of units p.i UUai"j _ $120lbld; + fio/unit
D Requested Inspections (of existing widng) - $40/fu (1 hr minimum) plus g40/hr thereafter
. ! TemporaryAmusement/Industry - $40 plus $10 per dde, concession or generator*Includes a maximum of 3 inspections. Additional i1nl,.ti.3. ch^atged at tequested inspection rate of g40 pet hour.** Includes a maximum of 4 inspections. Additional inspections chiged "t rlqoerted inspection tate of g40 per hour.
D Services: Alterations/Repairs that require "ofiV a ercial).
o Temporary construction Service, 200 amp ot less, one location (for a period not to exceed 1 year) - $40
tr Spa, Hot Tub, swimming pool - g40 plus g40 grounding grid where applicable
tr Electric Centrd Syslems Heating and/or Cooling (wben notpart of a new residcfiial constmctiott petmitaxd no additional wiing) - 940
tr Modular, Manufactured or Mobile Home - g50 plus $10 per circuit
other Installations: wiring not specificalry covered by *y of the above:cwt of lYiiry dz l'zbor $--------- ltnitt *i tle ,ost of nateials instathd rcgmdhs of tbe partl ,ilppbrns it).Pumps (Domestic Water, Itrigation, Sewage): horr". po*.,
oflicensed Contractor License numbet Date
Account : 10-37300. O0 Customer:
Name : LEWfS DENTAL OFFfCE
Serv Addr: 300 N 2ND E
Phone . (208) :ss -9459
0000002409
Delinq View: I
Credit Rate:
Last Bill- :
Last Pymt :
Start Date :
Dis Date :
Restart :
Trans Acct :
Pend Bal Remain Fix Winter Avg
A-r 1\7A k'l a-
Fina1 Flag :
Service Flag:
Clty Code : I
Dri nri f rr 1'd
Tax Flag :
No of Dwell- : l_
AccounL Type : B
Account Class :
Account Status:
Deliq Class :
Payment Type .
Energy Assist :
Turn Off Flaq :
Date | 06/L3/L2
Time : 14:53 :53
Page: 1
It li lr l
Bad Debt:
0s /3r / 12
08/os/os
Bal-ance Current Past, Due
vo. +l_
APP Bal- Pend
96 .4L
APP BAL Proj APP
96 .41 11.0000
69.25
Deposits Deposit Int Deposit Owed Req Deposit
MT Curr Usage Prlor Use 2nd Prior Curr Year Last, Year 2 Years Aqo
17.00 5.00 153.00
Adjusted Rd
Usage Fg
r_51.00
Meter
Number
r_53.00
Dial Co
No Cd
Per Reading
No Date
Beginning Ending
Reading Reading
MT
Ty
Bil 1
Code
ST
E'arY
CURR
1205
1_204
1203
1202
12OI
J_1_L2
1l_11
111- 0
110 9
l_108
J_1_07
110 5
1l- 05
11 04
r_103
L1_02
l_101
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Address
City of Rexburg il
Assignment Farm
City of Sugar City D A4odison County
E Curcent Addrass n Legal Description n Porcef No.
Narne: A nC'reru-.t ".\'tu--^o,..r ffr'il*,catn-[t o Date: b' /3 -t *
Assigned by:
t '2 ( -L(:(,I
Address: i/nA,e Parcel No' F*Krno-*g**?EG
Bfock: nt Lof: C5
Block: Lort:
Subdivision: L4 nt ller fr ,{cL,t"u'+-
City Blocik:
NewAddress: 67rl { E+1" fit
Addifionaf rnformation: Picd..se- a ss tcXn ct n c\.c*l r.<.s /. flu's
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Done NA
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12 00202
Dr. Andy Summers Orthodontics - Revisions
06104112
Dale Pickering (Please review by Thursday, June 7)
Routing:
Please complete the following:
Review Plans
Red Lines? (Amanda will transfer to all copies)
Enter Notes for the applicant under Submittals
Update status in the Approvals tab
Return site plan to Amanda Saurey
Done NA
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fw
nn
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Notes:
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Dr. Andy Summers Orthodontics
City Plan Review
Building Department:
Electrical Review - service and wiring to meet 200g NEc code.starting the project-revisions submitted in writing.
Areas to be noted prior to
Answer: Patient rreatment Room 105, Records Room 11s, consultation Rooms 11g and 120are the only areas dealing with patient care.
Mechanical Review - Are medical gases being used?
Answer: No
Building code Fire compliance - East walt and soffits must bet hour fire rated with Class ,,B,'
roofing. How is this to be done?
Answer: Move building west to place facia
Class "8". See attached drawing.
at 6'-3" from property line. Roofing material is a
structural Review - submit stamped and signed structural plans
Answer: see attached. Truss manufacturer to submit final trusslayout and calculations.
Energy conservation compriance - submit Energy carcurations.
Answer: Already submitted. lf you need another copy please ret us know.
Fire Department:
Water Supply - Plumb to code then red line the
Answer: Acknowledged
.9.0
t V I Envelope Gompliance Certificate
Itl
-
2009 rEcc
Section 1: Project Information
Project Type: New Gonstruction
Project Title : Dr. Andy Summers New Dental Office
Construction Site:
East 4th North
Rexburg, lD 83440
Section 2: General Information
Building Location (for weather data):
Climate Zone:
Owner/Agent:
Andy Summers
Rexburg, ldaho
6b
Designer/Contractor:
JRW & Associates
1 152 Bond Ave
Rexburg, lD 83440
208-359-2309
rmalm@jrwa.com
BuildingTypeforEnvelopeRequirements: Non-Fesidsntial
Vertical Glazing / Wall Area Pct.: 9o/o
Actlvlty Type(s)
Healthcare-Clinic
Section 3: Requirements Checklist
Floor Area
3204
Climate-Specif ic Requirements:
Component Name/Description Gross Cavity Cont. Proposed Budget
Area or R-Value R-Value U-Factor U-Factor(a)
Perlmeter
Roof 1: Attic Roof with Wood Joists 3274 50.0 0.0 0.021 0.027
Floor 1: Wood-Framed 32C . 38.0 0.0 O.O27 0.033
Exterior Wall 1 : Wood-Framed, 16" o.c. 2183 21'O 0.0 0.062 0.051
Window 1: Vinyl Frame:Double Pane with Low-E, Clear, SHGC 0.70 149 0.550 0.350
Door 1: Insulated Metral, Non-swinging 60 0.600 0.500
Door 2: Glass (> 50% glazing):Metal Frame, Entrance Door, SHGC 49 0.350 0.800
0.87
(a) Budget U-factors are used for soltware baseline calculations ONLY, and are not code requirements.
Air Leakage, Component Certification, and Vapor Retarder Requirements:
n 1. All joints and penetrations are caulked, gasketed or covered with a moisture vapor-permeable wrapping material installed in accordance
with the manufacturer's installation instructions.
2. Windows, doors, and skylights certified as meeting leakage requirements.
3. Component R-values & U{actors labeled as certified.
4. No roof insulation is installed on a suspended ceiling with removable ceiling panels'
5. 'Other' components have supporting documentation for proposed U-Factors.
6. Insulation installed according to manutaclurer's instructions, in substantial contact with the surface being insulated, and in a manner that
achieves the rated R-value without compressing the insulation.
g 7. Stair, elevator shaft vents, and other outdoor air intake and exhaust openings in the building envelope are equipped with motorized
dampers.
trtr
D
tr
tr
Project Title: Dr. Andy Summers New Dental Office
Daia filename: C:\Documents and Settings\bmillett\My Documents\COMcheck\Dr. Summers'cck
Report date: O3l2Ol'12
Page 1 of 2
E 8. Cargo doors and loa
g e, Recessed tishtins t,ff:.T:ffiil:ffiffJ::flilpe are rype rc rated as meetlsrM E283, are seared with sasker or caurk.g l0.Buirding entrance doors have a vestibure equipped with serf-crosing devices.Exceptions:
E Building entrances with revolving doors.
E Doors not intended to be used as a building entrance.
E Doors that open direcily from a space less than 3000 sq. ft. in area.
B Doors used primarily to facilitate vehicular movement or materials handling and adjacent personnel doors.
D Doors opening directly from a sleeping/dwelling unit.
Section 4: Compliance Statement
compliance statement: The proposed envelope design represented in this document is consistent with the buirding plans, specificationsand other calculations submitted with this permit application. The proposed envelope system has been designed to meet the 2oo9 lEccrequirements in coMcheckVersion 3'9'o and to comply with the mandatory requirements in the Requirements checkrist.
ry-j '2:1 4: , 2.
Signature
Project Title: Dr. Andy Summers New Dental OfficeData lilename: C:\Documents and Settings\bmillett\lr4y Documents\COMcheck\Dr. Summers.cck
Date
Report date: O3l2Ol12
Page 2 ot 2
.} ''\
12 0020r
Dr' Andy Summers orthodontics - Revisions
Routing: Building Review
Jon Berry (Please review by Friday, June g)
Please complete the following:
Review Plans
Red Line Notes? (Transfer notes to both job site copy & office copy)
Enter Notes for the applicant under Submittals
Update status in the Approvals tab
Retum building plans and this checklist to Amanda saurey
06/04/2012
@
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Done NAd'r
nd
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Notes:
Dr. AndY Summers Orthodontics
Gity Plan Review
Building DePartment:
Electrical Review - Service and wiring to meet 2008 NEC code' Areas to be noted prior to
starting the project-revisions submitted in writing'
Answer: Patient Treatment Room 105, Records Room 115' consultation Rooms 119 and 120
are the only areas dealing with patient care'
Mechanica|Review-Aremedicalgasesbeingused?
Answer: No
Buirding code Fire compriance - East wa* and soffits must be t hour fire rated with class "8"
roofing. How is this to be done?
Answer: Move building west to place facia at 6',-3" from property line. Roofing material is a
Class "B". See attached drawing'
Structura|Review-Submitstampedandsignedstructuralplans
Answer: see attached. Truss manufacturer to submit finar truss rayout and carcurations.
Energy Conservation Compliance - Submit Energy calculations'
Answer: Already submitted. lf you need another copy please let us know'
Fire DePartment:
Water Supply - Plumb to code then red line the print'
Answer: Acknowledged
12 0020r
Dr. Andy Summers Orthodontics - Revisions
Routing:
"trHBret Stoddard (Please review by Friday, June 8)
Please complete the following:
of" NA
E n Review Plans
M r Enter Notes for the applicant under Submittals
n Update status in the Approvals tab
I Return building plan to Amanda Saurey
Please indicate time spent in hrs/min reviewing the plans:
Notes:
06t04/2012
@
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Dr. Aridy Summers Orthodontics
Gity Plan Review
Building DePartment:
Electrical Review - Service and wiring to meet 2008 NEC code. Areas to be noted prior to
starting the project-revisions submitted in writing'
Answer: patient Treatment Room 105, Records Room 115, Consultation Rooms 119 and 12o
are the only areas dealing with patient care'
Mechanical Review - Are medical gases being used?
Answer: No
Building Code Fire Compliance - East wall and soffits must be t hour fire rated with Class "8"
roofing. How is this to be done?
Answer: Move building west to place facia at 6'-3" from property line. Roofing material is a
Class "8". See attached drawing-
Structural Review - Submit stamped and signed structural plans
Answer: See attached. Truss manufacturer to submit final truss layout and calculations.
Energy conservation compliance - submit Energy calculations.
Answer: Already submitted. lf you need another copy please let us know'
Fire Department:
Water Supply - Plumb to code then red line the print'
Answer: Acknowledged
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12 00202
Dr. Andy Summers Orthodontics - Site Plan
0610712012
Routing:
V H Joel Gray (Please review by Tues day,June 12)
Please complete the following:
Done- NA
V n Review revisions
Notes:
{
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n Enter Notes for the applicant under Submittals
n Update status in the Approvals tab
n Return revisions and this checklist to Amanda Saurey
-r.f r r
Planning Staff Review:
Site Plan - Provide flood plain certificate. Landscaping is needed. Parking lots are required to
be screened from view.
Answer: See attached.
Public Works Review:
Site Plan - No parking lot lighting shown or noted. Parking lots cannot drain into street.
Condition of existing curb and gutter? Parking stalls furthest from entrances have no place to
back into, making them non-functional.
Answer: No parking lot lighting use on project.
Will provide a curb cut in southeast corner of south lot to provide drainage to grass
area.
Will provide back-up turning outlet for parking stalls to the south.
12 00202
Summers Orthodontics Site plan
06/t2/2012
Routing:
Pgp" NA
$r Natalie Schneider (Please review by Thursday, June 14)
Please complete the following:
ne NA
n Review Plans
n Enter Notes for the applicant under Submittals
n Update status in the Approvals tab
r Return Site Plan & this checklist to Amanda Saurev
$,$
$
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Please indicate time spent in hrs/min reviewing the plans: \5 n",\n
From:
Sent:
To:
Cc:
Subject:
Amanda Saurey < amandas@rexburg.org >
Friday, June 08, 2012 L1,:I2 AM
Ryan Malm
rexortho
Summers Orthodontics Revisions
Hi Ryan,
There are still a few outstanding items for the Summers Orthodontics permit remaining after your most recent
revisions that were turned in last week.
l. Still need the flood plain certificate. (site plan review) %tr frtt*ga+ep
2. (public works review) Still need prior items shown on plans with elevations and details submitted along
with storm drainage calculations submitted. Lighting was addressed and acceptable.
a. Parking lots cannot drain into street. 4gZ ,+ttALrlre\>
b. What is condition of existing curb and gutter inp Fl^{t=.
c. Parking stalls furthest from entrances are not functional without a place to back into. j€ AtntcdtD
3. If subcontractors have been awarded, I will need their applications with bid amounts to determine thepermit fee.
Please contact me with any questions.
Thanks,
Amzurda Saurey
The City of Rexburg
Permit Teclurician
P.O. Box 280
35 North lst East
Rexburg, Id 83440
208-359-3020 ext. 2341
luniur<las@rcxl>ur g.or g
No virus found in this message.
Checked by AVG - www.avg.com
version: 2012.0.2178 / Virus Database: 243315056 - Release Date:0610g112
U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATEFederal Emergency Management Agency
National Flood Insurance Program lmportant: Read the instructionS on pages 1-g.
OMB No. 1660-0008
Expires March 31,2O12
SECTION A. PROPERTY INFORMATION
A1. Building
M.Bui|dingStreetAddress(inc|udingApt.,Unit,suite,and/offi
A.4.
45.
A6.
A-7.
48.
Building use (e.9., Residential, Nop-Residential, Addition, Accessory, etc.) 46rq na.Eerl xt-.Latitude/Longitude: Lat@1!.'45ng. tlloas'Zt.zs"vy'Horizontat datum: ilrunO 1927 Ef NAD 1983Attiach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.Building Diagram Number fi
For a building with a crawlspace or enclosure(s):
a) Square footiage of crawlspace or enclosure(s)
b) No. of permanent flood openings in the crawlspace orenclosure(s) within '1.0 foot above adjacent grade
A9. For a building with an attached garage:
a) Square footage of attrached garage3,2o7 sq ft
_r
.'{ sq inc)
d)
b) No, of permanent flood openings in the attiached garage
within 1.0 foot above adjacent grade
sqft
sq in
No
Total net area of flood openings in A8.b
Engineered flood openings? E yes Ef'l,,lo
c) Total net area of flood openings in Ag.b
d) Engineered flood openings? ! yes D
SECTION B. FLOOD INSURANCE RATE MAP
84. Map/Panel Number
L{ooEz-eozo
ts5. Suftix
?
86. FIRM Index
Date
87. FIRM Panel
Effective/Revised Date
fuue 3. nq I
88. Flood
Zone(s)
AE
89. Base Flood Elevation(s) (ZonE
AO, use base flood depth)
4A10. {B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depih entered in ltem Bg.
D FtsProfile E"ptnfr4 fl CommunityDetermined E Otner(Describe)_
811. IndicateelevationdatumusedforBFEinltemBg: E NGVD1929 B-NRvotsgg E other(Describe)_812' ls the building located in a Coastal Banier Resources System QB!!) area or otherwise protected Area (opA)? D vesDesignarionDate_ bCairS DOpA
SECTION C. BUILDING ELEVATION INFORMA@
c1.
c2.
t urtorng etevauons are based on: EI Construction Drawings. ! Buitding Under Construction*? new Elevation Certificate will be required when construction of-the building ifcomplete.
Building elevations are based on:
Top of boftom floor (induding basement, crawlspace, or enclosure flooi 4gn7 . Q I
Topof thenexthigherfroor 4Sf.l_.AOBottom of the lowest horizontal structural member (V Zones only)
Attached garage (top of slab)
EIfeet
I finished Construction
fl meters (Puerto Rico only)
! meters (Puerto Rico onty)
E meters (Puerto Rico only)
E meters (Puerto Rico only)
I meters (Puerto Rico only)
Elevations - Zones A1-A30, AE, AH, A (with BFE), vE, v1^-Y39: V (with BFE), AR, AR/A, ARUAE, AFyAI-A3o, AR/AH, ARyAo. complete ttems c2.a-hbelow according to the building diagram specified in ltem A7. Use ihe same datum as the BFE.Benchmark Utilized Vertical Datum _
Conversion/Comments _
Check the measurement useo.
6*, E meters (puerto Rico onty)
Wt".t E meters (puerto Rico only)
E feet E meters (Puerto Rico only)
a)
b)
c)
d)
e)
f)
s)
h)
Lowest elevation of machinery or equipment servicing the building(Describe type of equipment and location in Commene)
Lowest adjacent (finished) grade next to building (LAG)
Highest adjacent (finished) grade next to building (HAG)
Lowest adjacent grade at lowest elevation of deck or stairs, including
4La3-.l-,:
4ilp-.oo
D feet
EJPet
dfeet
V{nt
SEcTIoN D - suRvEYoR, ENGINEER, on nnCrInEEi cEffiipll
licensed land I Yes Kruo
L**-_--*_.:;J
FEMA Form 81-31, Mar 09 See reverse side for continuation.Replaces all previous editions
FoTGHN r,*
0.383 ACRE LEGAL DESCRIPTION
FOR DWAYNE HANSEN
SMUATED IN THE STATE OF IDAHO, COUNTY OF MADISON, BEING PART OF TI{ENORTI{WEST QUARTER oF sEcrIoN 20, TowNsHIp 6 NoRTH, riaxcn 40 EAST oF THEBOISE MERIDIAN, BEING PART OF LOT 2 BLOCK 2, WALKER ADDITION DTVISION NO. 2,CITY OF P.EXBURG AS CONVEYED TO DM }IANSEN ENTERPRISES, LLC. oF REcoRD ININSTRUMENT #334800 AND BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS;
BEGINNING AT A REBAR WITH A PLASTIC CAP FOIJND MARKING THE NORTI{WESTCORNER OF SAID LOT 2 BLOCK 2;
T}IENCE NORTH 89" 47' 47'' EAST, A DISTANCE OF 129.99 FEET WITH TTIE NORTH LINE OFSAID LOT 2 BLOCK 2 AND THE SOUTH RIGHT-OF-WAY LINE OF 4TH NORTH STREET TO A5/8'' REBAR WITH AN ALUMINTTM CAP SET;
THENCE SOUTH OO" 12' I3'' EAST, A DISTANCE OF 176.00 FEET OVER AND ACROSS SAIDLOT 2 BLOCK 2 TO A POINT, BEING REFERENCED BY A 5/8' REBAR WTTH AN ALIIMIN{.IMCAP SETNORTH 89"47'47- EAST, DISTANCE OF 5.OO FEET;
THENCE SOUTH 896 47'47'' WEST, A DISTANCE OF 3.OO FEET WITH T}IE SOUTH LINE OFSAID LOT 2 BLOCK 2 TO A POINT, BEING REFERENCED BY A 5/8'REBAR WTTH ANALUMINUM CAP SET NORTH 89"47'47' EAST, ADISTANCE OF 8.OO FEET;
THENCE WITH THE RIGHTOF-WAY OF WALKER DRTVE AND THE SOUTH LINE OF SAIDLOT 2 BLOCK 2 WTTH AN ARC OF A CURVE TO THE LEFT HAVING A RADruS OF 62.00FEET, A DELTA ANGLE OF 142"22'52', AN ARC LENGTH OF 154.07 FEET, SAID CURVEHAVING A CHORD BEARING OF NORfi{ 71" 26' 28'' WEST, A DISTANCE OF I IZ.gg rBgrrO AREBAR WITH A PLASTIC CAP FOTIND MARKING A POINT OF REVERSE CURVATURE;
THENCE WTTH THE RIGHT-OF-WAY OF WALKER DRTVE AND THE SOUTH LINE OF SAIDLOT 2 BLOCK 2 WITH THE ARC A CI.]RVE TO THE RIGHT HAVING A RADruS OF 2O.OO, ADELTA ANGLE OF 52O25'4I'0, AN ARC LENGfi{ OF 18.30 FEET, SAID CURVE HAVING ACHORD BEARING OF SOUTH 630 34'56" WEST, A DISTANCE OF 17.67 FEET TO A 5/8' REBARWTTH AN ALI.]MINUM CAP SET MARKING TIM SOLTftIWEST CORNER OF SAID LOT 2BLOCK 2;
TI{ENCE NORTH OOO 12' I3'' WEST, A DISTANCE OF 146.05 FEET WTrH THE WEST LINE OFSAID LOT 2 BLOCK 2 TO THE TRUE POINT OF BEGINNING, CONTAINING 0.383 ACRES OFLAND, MORE OR LESS.
THE ABOVE DESCRIPTION WAS PREPARED BY FORSGREN ASSOCIATES, TINDER T}IEDIRECT SUPERVISION OF JEFFREY M. ROwE, PLs 13856 IN MAY 2012, AND Ib sUgrgCT roEASEMENTS AND RIGHTS-OF-WAY OF RECORD.
VtMffatt^eycn
12 00201
Dr. Andy Summers Orthodontics
05104112
Routing:
Done NAvIr Bret Stoddard (Please review by Wednesday, May 9)
Please complete the following:
NA
I Review Plans
I Enter Notes for the applicant under Submittals
I Update status in the Approvals tab
t Return building plan to Amanda Saurey
Do{e
il
{
{
{
Please indicate time spent in hrs/min reviewing the plans:
^ fk'
Notes: k .xx^s ?,l,l.,,\^ttr S* tA_*kl_5)"t*s,
12 00202
Dr. Andy Summers Orthodontics - Site Plan
0sl02l12
Routing:
"tr H Dale pickering (please review by wednesday, May 9)
Please complete the following:
t
{
{ { Update status in the Approvals tab
Return site plan to Amanda SaureY
-a Qrrw M)
!T
Notes:
.[Jo no\es
DoY NA
M I Review Plans
Red Lines? (Amanda will transfer to all copies)
Enter Notes for the applicant under Submifials
12 00202
Dr. Andy Summers Orthodontics - Site plan
0st02t20t2
Routing: Office Copy
NA
! Natalie Schneider (Please review by wednesday, May 9)
'$:'
Please complete the following:
Dpne NA
Y ! Review plans
r
s- tl Enter Notes for the applicant under Submittals
I\r
N Il Update status in the Approvals tab
I
\rfr h
X ! Return site Plan & this checklist to Amanda saurey
I
Notes:
Site Pfan Review Checkfist
n^_ ^ .rZone: (--,(_\''\ lnLin i\Lf
Surrounding Land Uses: J
Elevations submitted:
Landscape Plan submitted:
Lighting Pfan subrnitted:
Project:
Permit #
Evt\r*1pgg 0ct-e.
Use Consistent with zoning designation
Compliance with Comprehensive plan
Flood Plain Gheck
Plans are to scale
Building Coverage
Frontyard yeqt\\reNneq\
Side yard O'
'qn
Min im um distance between brlildt-ngs
Driveway, parking tot dimensions
Parkingspace# rr, -----
\ 1 Y en\i\Y
Unloading, loading area
Parking spaces located in ctos@
along right of way
I nternal pedestrian walkways
Open/common spacel runEiiorGl?
Fencing/screening (HVAC eq
rash dumpster shown and screened
Buffering/landscaping requirements -1,r2
t(-
Committee
r
Madison County I City of Rexburg GIS
Z--
Page 1 ofl
DISCLAIMER: This map is intended for display purposes only and is not intended for any legal representations.
http://gis/intranet/arcims/printable.aspx?MapuRl:http://agentsmith/output/arclMS_agents... 51412012
12 00202
Dr. Andy Summers Orthodontics - Site plan
05t04t2012
Routing:
Doje NA
M U Joel Gray (Please review by Thursday, May l0)
Please complete the following:
NA
f Review Plans
I Enter Notes for the applicant under Submittals
I Update status in the Approvals tab
n Return Site Plan to Amanda Saurev
Notes:
oot'
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Dolf NA
An
t2 0020r
Dr. Andy Summers Orthodontics
0sl04l12
Routing: Copy 3
Don Allen (Please review by Wednesday, May 9)
Please complete the following:
NA
I Review Plans
n Enter Notes for the applicant under Submittals
n Update status in the Approvals tab
n Return building plan to Amanda Saurey
Notes:
tr
,{
/
.a
12 00202
Dr. Andy Summers Orthodontics
0511012012
Routing:
Keith Davidson (Please review by Monday,May 14)
Please check the following and provide calculations if fee is required:
Yes Nn/
I g Front Footage Water Fees
Front Footage Sewer Fees
Storm water Fees
Other
n Return checklist to Amanda Saurey
Notes:
{
{
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s
05/04/2012
12 00201
Dr. Andy Summers Orthodontics
Routing:
oo{ NA
dr Jon Berry (Please review by Thursday, May 10)
Please complete the following:
DoY NA
f, ! Review plans
( Red Line Notes? (Transfer notes to both job site copy & office copy)
Enter Notes for the applicant under Submittals
Update status in the Approvals tab
Return building plans and this checklist to Amanda Saurev
!
{
V
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Notes:
Routing:
Done NA6x
12 00201
Dr. Andy Summers Orthodontics
06t13/2012
John Millar (Please review by Friday, June l5)
Please check the following and provide calculations with required fees:
Yes NA
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F. n Return checklist to Amanda Saurey
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JOB NUMBER
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IDAHO FALLS, IDAHO
OFFICE: 12o,815?2'1244FAX: [2O8] 522-9232
REXBURG, IDAHO
OFFICE: t208l 356-6092
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