HomeMy WebLinkAboutAPPLICATIONS, RECEIPT - 12-00449 - BYUI Storage Bldgcll).r,1
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COMMERCIAL & MULTI FAMILY BUILDING PERMIT APPLICATION
35 N 1" E, REXBURG.ID 83440
208-372-2326
PARCEL NUMBER:
SUBDIMSION:
We will provide this for you)
UNIT# BLOCK#-LOT#
Add is based on the information - must be accurate
CONTACT PHONE # ?.
PROPERTY ADDRESS:
PHONE #: Home &)ry 4%-? t t3 Work p.Aq 4 1& ,y I &3 cen 1 )
or{,NERMAILINGADDRESS,4qos' Ftr** f,t4 Ftrv, !?.a w4 srATE: f /,/np, #3 4 J'J
EMarr i'1r.,"&yf(d $yr,f i.z/nFAX_
APPLICANT: (If other than owner)
(Applicant if other than owner, a statement authorizing applicant to act as ageit for owner must accompany this application.)
APPLICANTINFORMATIoN: ADDRESS &4$ € S, T**il{e CITY, S /-d,;
STAUE; b( | np-t!-!!L EMAII r n re,fsr', @jrsq -ss,tnFAX
PHoNE #: Home ( )_ sfork V"/), ?4 / - 6F i,3 c.n VJi 3 F S -l€W
MAILING ADDRESS:CITY-STATE ZIP
PHONE,: Cell#
EMAIT IDAHO REGISTRATION # & EXP. DATE
How many buildings are locared on rhis property?
Did you recently purchase this oroperty?S? Yes Qf yes, list previous owner,s name)
Is this ^ tot sputffd YES (Please bring copy of new legal description of property)
PROPOSED USE:
(i.e., Single Family Residence, Mulri Family, Apartments,l,Garage, Commercial, Addition, Etc.) - CIRCI.E ONE
*:, !{9q :tocial may rmke a permit on approval issued undir the.provisions of the 2003 Internationat code in ."r., or -y i"trJ ,;;;.;;;;;tJr!plJ.Jr,.,io, or r".,in the application or on the plms on which the pemit lwsbged. Per.ryitvoidifnotstartedwithinl80days. pemitvoidifworkstopsfort00days.
Signature of Owner/Appl-icant
Do you prefer to be contacted by
lilr t /Lblz-
DATE
r phohe? Circle One
VAIiNING\DUII*DING PERMIT MUST BE POSTED ON CONSTRUCTION SITETPlo feee ae ron-reftradable and *e paid in 6rll ar the time of applicationbegfunngllgryJ,-&AL
- _ City of Rexbug's Acceptance of tlre plan review fce doee not consrit.rt. pt"n=ippr"""t
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APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: underpmartyof periury,rhcebycertiffthatrhave read this application md state that the infomation here.in is corect md I swear that any infomation which may hereafter be given by mi in herings before thePlanning md Zoning Commission or the City Comcil for the City of Rexburg shall be t-thiul md correct. I agree io comply with au City regulations aid State laws relatingto th€ sbject metter of this application md hereby authorized representatives of the City to entet upon the abolve-m.rtior.d prop.rty foi insiections purposes. NoTE:
r*Building Pemit Fees ue due at time of applicarion** **Buitding Pemits are void if you iieck does nor ctea1+*
Business
35 North I't Eost
Rexburg, lD 83440
Applicofion c t'l'1' o i
Phone: 208.359.il20
Fox: 208,359.3022
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Please take the time to answer all questions so that we can further asskt you and your facili4t Thank You.
What type of business will be performed
Will the business have food preparations?
Will there be any cooking of foods?
Will there be any deep fat fnring?
Will you have food disposal on site?
Will there be any maintenance or mechanical work in the building?
Will there be sumps or floor drains in the facility?
Will the business require more parking?
Will the business have any chemicals on site ?
Is this business occupying an existing building?
Will the business be doing any structural/or remodeling changes to the building?
Any changes to the electrical?
Any changes to the plumbing?
Is this business planned to be the same with different ownership?
Will there be a change of occupancy?
Yes No
Yes L.rz No
Yes /'o No
Yes
Yes
t"-1 No
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Yes No
Y", /No
Not'
No
No
Yes
Yes
Yes
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Yes
No tr-
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No
Yes Nof
Yes No u{
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PhoneApplicants SignaturefrppuuanrsDrgnarure w, /i rnone I
I Certify that The information that I have provided abo96 is to the best of my knowledge accurate and true.
Building Sofety Deportmen
www.rexourg.org
Remode/ing' Fozr&zzTdzng/Home (needrotalconstructions estimate, excluding fire,
ct.it'c!City of Rexburg
Phone: 208.372.2326
Fox: 208.359,3022
SEEXBMlG35N isf E
Rexburg. lD 83440
electr{cal, plumbing, and Mechanical valuatio"g $ h ri r*J}j ,,}
ReszVeztza/
SIIRFACE SQUARE FOOTAGE: (Shall include the exteriorwall measurements of the building)
Fint Floor Area Unfinished Basemenr area
Second floor/loffiinished basement area
Third floor/loft area Garage area.
Shed orBam CarpordDeck (30" above grade)Area
^a>.,LOmmerczal
C-onstruction Tlpe: li R occupancyTle., A 5
SURFACE SQUARE FOOTAGE: (Shall include the exteriorwall measurements of the building)
New C.onstruction sq. ft. ih * , i"h _f < j
Commercial Remodel sq.ft. *-f I j
Commercial Addition sq. ft. \ b I {'}} :$
Utiliry Misc. Private Garage sg.ft,
Storage sq. ft,
/U///tz:.Fanih/,ftbgbstudentEozszzg:
sq. ft. per unit
lvfanagerUnit sq. ft.
Building Sofety Depqrlmenl
Phone: 208.372.2326
Fox: 208.359.3022
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Affidavit of Legal Interest
State of Idaho
Countv of Madison
A.attached, and I grant m
to submit the accompanying application pertaining to thar properuy.
B' I agree to indemnify, defend and hold Rexburg City and its employees harmless from anyclaim or liability resulting from any dispute as to the statements contained herin or as to theownership of the properry which is the subject of the application.
I
Dated *"" ?n4 day of oqb$@-20 L2-
t, L44 e-t*S N. a*>e4gfi
Name
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Citv
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, skip to B)
subscribed and swom to before me the day and year first above written.
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Address
Gr ar
62V/62_
My commission expires F Pt/'Zt
Building Sofety Deportment
City of Rexburg
Phone: 208.372.2326
Fox:208.3593A22
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ii t,t.'fii!l:r i:iu ii i l), ! ii t i, tu i ii itRexburg. lD 83440 www.rexburg.org
Business Application Questionaire
(for the purpose of wasrewater permitting)
1,.
2.
aJ.
7.
B.
9.
10.
4.
5.
6.
\X/ill there be any deep fat frying? Y.r__X_ No
Will the faaJtty have food disposal systems?
Are you a business planning to occupy an existing building?t| \-.
or> ^te you designing a new facility? Y< J
\Will your business have chemical storage? yes X No
\07ill this facility operate year round? Yes X No
\Will there be any grease traps or sumps at the facility? yes X. No
Will there be any tyPes of chemicals used at this faci)tty,other than household
cleaning solutions? Yes _j(_ No
1.1- Is there any manufacturing of products at this facrJtty? yes _
Type of business or establishment?
'sfill this business be doing any rype of food preparation or cooking?
What typ. ?f food prepa:atlo:r orcooking will be done?
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Building Sofely Deportment
City of Rexburg
Phone: 208.372.2326
Fax: 208.359.3022
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Permit Number:
B
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www.rexburg.org
Site Plan Checklist
Application Information
l nD lr IAppf icant: _Ja.lt N ls (>rm phone: VDI- t\l_- 1.?t3 FAX, _Applicant's Address: /,rtrt € 3",r1,f, },*^f.io City: S i'C ST: H* Zlp, 31:14-Project Address:
Development Information
l - Site plan must be drawn to scale, be legible and also be submitted electronically if possible.
2. Adjoining streets labeled.
3. Right-of-way location and width, curb to curb widths and sidewalk location.
4- Building location, sq footage and dimensions, with distance to property lines and distances
between buildings.
E} 5. Show existing and proposed easements.
E[ 0. Existing utilities (waterlines, sanitary sewer lines, manholes, storm drains).
E l - Proposed utilities including tie in location to existing services and new easements.
A S- Proposed storm drain and sanitary sewer elevations (for pipe inverts at manholes and catch basins).
6 g. Storm drainage plan for parking lot and roof areas, with calculations.
E to. Fire hydrants and fire suppression lines (including tie to city lines).
8I Sprinkled D Not Sprinkled
EI 1 1. lndicate Fire apparatus access.
I tZ- Parking (including parking lot, drainage arrows, dimension of lot, distance between rows. and total
numbers).
8 13. Landscaping (type and total area, including dimensions.;.
X t+. Trash facilities.
EI 15. North Arrow
Er 16. Drawing to Scale, including a graphic scale (l I yz x 17,, paper if possible).
P 17- Proposed street improvements (curb, gutter, sidewalk, pavement, etc.)
tr 18. Legal description of proposed building site included.
A 19. Percent of lot covered by building or paving calculated.
tr 20. Show l0% snow storage area.
,Ff 2l. Distance of entrances from street comer indicated.
9 22- Current Vicinity Map. (81/2 x 11") at 1": 300' scale, showing location of the property.
*W23. Lighting Plan
ENOTE: SITE PLANS MUST BE COMPLETE AND SUBMITTED FoR REVIEw BEFoRE THE PROJECT wILL BE
PLACED ON THE PLANNING & ZONING AGENDA.€