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Home My WebLink AboutAPPLICATIONS, RECEIPT - 12-00450 - BYUI Flammable Storage BldgREXBURG c\' "-"'-"'- Ame rica\ Family Co mm uni ty COMMERCIAL & MULTI FAMILY BUILDING PERMIT APPLICATION 35 N 1" E, REXBURG, ID 83440 208-372-2326 PARCEL NUMBER:We will provide this for you) SUBDIMSION:UNIT# BLOCK# LOT# How many buildings are located on this property? Did you recently purchase this property?$ Yes (If yes, list previous owner's name) Is this a lot ,putlffd YES @lease bring cop1,of new legal description of properry) PROPOSED USE,: (i.e., Single Family Residence, Multi Family, Apartments,,Ga;tage, Commetcial, Addition, Etc) - CIRCT.F ONE APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: underpenalryof perjury,Iherebycertifythatl have read this application md state that the infomation herein is correct md I swer that my infomation which may hereafter be given by me in herings before the Plaming md Zoning Commission or t}re City Coucil for the City of Rexburg shall be truthful md cotrect. I agree to comply with all City regulations and State laws relating to the subject matter of this application md here\ authorized reptesentatives of the City to enter upon the above-mentioned ptoperty for inspections purposes. NOTE: The building official may revoke a pemit on approval issued udet the provisions of the 2003 Intemational Code in cases of my false statement or misrePresentation of fact in the application or on the plans on which the permit ol apgloval was baped. Peggrit void if not staned within 180 days. Permit void if work stops for 180 days. Signature of Owner/Apphcant Do you prefer to be contacted by lil r t / ?_01?* DATE phoir? Citcle One PERMIT MUST BE POSTED ON CONSTRUCTION SITE! Plm feee re non-tefundable md re paid in full et the time of application begiming IWryS,W City of Rexbutg's Acceptmce of the plm siew fee doee not constitute Pl.n aPProval *rBuilding Pemir Fee8 rc due at rime of applicationtt *rBuilding Pemite re void if you check does not clear** ' I'l Y li I v'1. n I CONTACT PHONE # PROPERTY ADDRESS: PHoNE #: Home Qdq 4%-) I {.> \rork Q.Aq tt "tt.7l 13 cen( ) o\'(AIERMAILINGADDRESS, 1qoS, r{l,tttta ilr\ trqrcv, i?-o:t'bt sTATE: lr-/np, 81tt lt) APPLIC'LIIT (If other than owner) (Applicant if other than owner, a statement authorizing applicant to act as agent for ovmer must accomPany this application.) APPLICANT INFORMATION: ADDRESS (4^ F S, a+'t'r.',lt CfiY: S LC" stmp; 0{ | zw-tt4l}L riM'\rr tnp,lkn@}vsq'a,.trngtX PHONE #: Home (work g$ 741 ' 68 13 crn $,il -r F 5 'tf 8* MAILING ADDRESS:CITY-STATE ZIP EMAIT IDA}IO REGISTRATION # & EXP. DATE Building Sofety Deporlmenl Phone: 208.372.2326 Fox:208.359.3022 State of Idaho County of Madison l, (4.Itet*s *1. n*t>f:tzser) Affidavit of Legal Interest 'lpo krftfl\uL Address IDt*c> &' Name Being first duly sworn upon oath, depose and say: (If Applicant is dso Ownet of Record, skip to B) A. That I am the permission to: of the property de,scribed on $_e attached, and I grant m crLh Address to submit the accompanying application pertaining to that property. B. I agree to indemniS', defend and hold Rexburg City and its employees harmless from any claim or liability resulting from any dispute as to the statements contained herin or as to the ownership of the property which is the subiect of the application. Dated thi" ?/44 day of o4ooe-20 T'L Subscribed and sworn to before me the dav and vear first above written. e?/o> Residing at: Szt > . caxtru--tB /6zts ttLExBtsZ6 Mycommission expires: APtrztt /t, Zo t 7 Name Signatute Building Sofety Depqrfmenl www.rexourg.org City of Rexburg Phone: 208.372.2326 Fox: 208.359.3022 Busines s Application Questi onaire (fot the purpose of wastewater permitting) 2. Will this business-be doing any t5pe of food Prep^ratlon or cooking? \u, Will there be any deep fat frying? Yes X No Will the facitty have food disposal systems? 7. 8. 9. 10. CITY OF REXBURG Tlpe of business or establishment?1. 3. 4. 5. 6.Are you a business planning to occupy an existing building? lto o\ ^re you designing a new facility?\<g Will your business have chemical storage? Yes X No Will this facthq operate year round? Yes No Will there be any grease ffaps or sumps at the facility? Yes X No Will there be any types of chemicals used at this facility, other than household cleaning solutions? Yes X No 1.1.. Is there any manufacturing of products at this facility? Yes - No Y tA-l-lz lfhat t)?e gf food prepar^tton orcooking will be done? Date Building Sofety Depqrfmenl City of Rexburg Phone:208.372.2326 Fox:208.359.3022 Checklist Information www.rexourg.org CtTY OF REXBURG c5" "-..****- Ame r i ca s Familv Communitv35N l.tE Rexburg, ID 83440 Site Plan Application Permit Number: Ats,4 EI epptlcant: =leff N,<-[:* ptrone: fDl-'7rlt*c813 FAX:- Applicant'sAddiess:44.i€ S"r+1" T*{li* City: SLC ST: U} Zip: t4lDA Project Address: Recorded Owner: BYIJ - L'a h " Phone: :2Og- LO'I-L ilA FAX: Recorded Owner Address:ST: )zf Zip: Y34L0 Development Information 1. 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. A 5. Show existing and proposed easements. E[ 0. Existing utilities (waterlines, sanitary sewer lines, manholes, storm drains). 8 l. Proposed utilities including tie in location to existing services and new easements. tr S. Proposed storm drain and sanitary sewer elevations (for pipe inverts at manholes and catch basins). 4 g. Storm drainage plan for parking lot and roof areas, with calculations. E 10. Fire hydrants and fire suppression lines (including tie to City lines). 8[ Sprinkled E Not Sprinkled EI I l. Indicate Fire apparatus access. I tZ. Parking (including parking lot, drainage arrows, dimension of lot, distance between rows, and total numbers). I 13. Landscaping (type and total area, including dimensions). F ru. Trash facilities. .EI 15. North Arrow Etr 16. Drawing to Scale, including a graphic scale (11 Yrx 17" paper if possible). g 17. Proposed street improvements (curb, gutter, sidewalk, pavement, etc.) tr 18. Legal description of proposed building site included. D 19. Percent of lot covered by building or paving calculated. D 20. Show 10% snow storage area. s|zl. Distance of entrances from street corner indicated. 9 ZZ. Current Vicinity Map (8112 x 11") at I" :300' scale, showing location of the property. *dzl. Lighting Plan €NOTE: SITE PLANS MUST BE COMPLETE AND SUBMITTED FoR REVIEw BEF,oRE THE PRoJECT wtLL BE PLACED ON THE PLANNING &ZONING AGENDA.€ Business Applicotion CITY OF 35 North lst Eost Rexburg, 1P 6Jaa0 Phone: 208.359.3020 Fox: 208.359.3022 REXBURG c\, '---'-*"- Ameicai Family CommuniV Please take the time to answer all questions so that we can further assist you and your facility 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 frying? 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 chernicals 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 b' No Yes I No Yes &"" No Yes f"t No Yes Not' Y", &"" lvo Yes_No '/' Yes / No Yes No L./ ,./' tto t/Yes Yes_ No A- t- Yes No Yes Yes Nof Not' Applicants Signature tdt--t59 -tqs L !ft -l, ta" Phone Datev ItI Certily that The information that I have provided aboVe is to the best of my knowledge accurate and true Buil ng Sofety Deporlme OF 35N lsrE Rexburg, ID 83440 www.rexburg.org City of Rexburg Phone: 208.372.2326 Fox: 208.359.3022 REXBURG Am e ri ca\ Fami ly Co mmu nity Remode/zng Tour,RzzHzhg/Ilome (needtotal constructions estimate, excluding fire, electrical, plumbing, and Mechanical valuationO $ el 0,{}b | )itt ReszVentzh/ SURFACE SQUARE FOOTAGE: (Shall include the exteriorwall measurements of the building) Fint Floor Area Unfinished Basement area Second floor/loft "area Finished basement area Third floor/loftarea Gange area Shed orBam Carpor/Deck (30" above grade)Area Commercza/ Construction Type: l\ R occupancyryp.' A) SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) New C-onstruction rq. ft. tll" il r i$ -\ S j Commercial Remodel sq.ft. a- fr t$ C-ommercial Addition ,q. ft. tr \ I ['l] ,l Utility, Misc. Private Gange sq. ft.. Storage sq. ft. l,/u /tz'-,Fam zT/,fingb,ftzde n t .tTo zs zng sq. ft. per unit I\{a.nager Unit sq. ft.