HomeMy WebLinkAboutALL DOCS, CO - 12-00560 - 160 W 2nd S - Skeeters - RemodelCI-IY OF Gertificate of Occupancy
City of Rexburg
Department of Gommunity Development
35 N. 1st E. / Rexburg, lD. 83440
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:
Gontractor:
Special Conditions:
12 00560
International Building Code 2009
160 W 2nd S
Skeeters
Type ll, non-rated, non-combustible
75
Yes
Dewsnup Colin
3640 Sage View
Kimberly, lD 83341
Owner/Lessee
Occupancy:Assembly -Food and/or drink consumption
This Certificafe, issued pursuant to the requiremenfs of Section 109 of the lnternationat Building
Code, certifies that, at the time of issuance, this building or that portion of the buitding that was
inspected on the date listed 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,
Date G.O. lssued:-r/;A
G.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 until the Building Official has reviewed andapproved said future changes.
Fire lnspeca,
P&ZAdminisrraror Al { /+
Building Official
Plumbing Inspector:
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I,Building Sofely Depqrlment
www.rexDurg.org
CTTY OPCity of Rexburg
Phone: 208.372.2341
Fox: 208.359.3022
REXBURG
Anu ricub Family Community
Office Hours: Monday-Fdday 8:00am-4:00pm
Seismic Design Category - D
(unless soil evaluation confirms category C)
Ground Snow - 50lbs. pet sq. ft.
Roof Snow Load - 35 lbs. per sq. ft.
Wind Load - 90 MPH
Frost Depth - 36"
Thefollowing inns should be conpleted before)tou subnitlour buildingperruit application. INC1MpLETE
APPLf,CATIONS WLLNOT BE ACCEPTED.
Completion of a Building Petrnit Application: Youmay print this application ftom our website
www.texburg.otg ot pick up a copy at the city Annex Building (address atove).
Commerci aI Permi t*, (the
E 4 sets of site plans
following must be submitted with the Application)
and 3 sets of building plans stamped by a licensed professional
Sttuctual Calculations stamped by a licensed Engineer
Enetgy Compliance Repott: As per the 2006IECC, a Compliance check must be completed and submitted
(the comcheck is available online at www.energycodes.gov).
Page 2 of the Application must include the Idaho Conftactor's Registration Numbet or the exemption form
must be completed and signed, see Page 10.
Page 5 of the Application must be completed and signed by yout plumber.
Page 6 of the Application must be completed by signed by your Mechanical Contactor.
Page 7 of the Application must be completed and signed by your Electdcian.
Electdcal panel layout and calculations must be included with the building plans. Plans will bereviewed by the electdcal inspector prior to issuance of the building permii."
The Elecftical application must include engineer stamped dtawings for all commercial projects.
Emergency Services Construction Permit-for fire related equipment only; to be filled out by the
contractot performing the work.
Exterior Lghti"g Plan including photometric layout. The lighting standards ate included in this packet.
Ptoperty Line fotm needs to be signed by the builder, see page 4.
Electdcal Petmits are now issued through the City of Rexbutg. See Page 6 of the application.
Remodels' If you are consideoog^ remodel, a copy of the bid or estimate for the remodel must be submitted
with the Permit Application.
. 3 set of plans (may need IECC Review)
. Additions - Same as new construction
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Please Comp'Fle the Entirc Application!
If the question does not apply 6ll in NA for non applicable
35 N 1" E, REXBURG,ID 83440
208-372-2326
PARCEL NUMBER:
SUBDIVISION:
-(We will provide this for you)
UNIT# BLOCK# LOT#
on the information - must be accurate
Coxrecr PHoNE # 't3l-YDtr
PROPERTYADDRESS, luav l-'a.- ) (Lo"L*,y lD s*.b .lll. ^ --
PHONE #: Home ( )\fork ( )
O\XII\E,R MAILIN G ADDRESS :tzCflY:
APPLICANT (If othet than ownet)
(Applicant if othet t]ran owner, a statement
''njrthoizifrgapplicant to act as agent for ownet must accomPany this application')
APPLICANT INFORMATION: ADDRE,SS CITY:
STATE: ZTP- E,MAIL FAX
PHONE #: Home ( ).- Work ( )Cell (
MAILING ADDRESS:C ITY--S T ATE __--__:ZTP
PHONE: Cell#
EMAIL IDAHO REGISTRATION # & EXP. DATE
(If yes, list ptevious owner's name)
Is this a lot split? NO YES (Please bdng copy of new legal description of ptopetty)
PROPOSED USE: z s
(i.e., Single Family Residence, Multi Family, Aprtt*""tt4{"*.@ Gatzge,Commercial, Addition, E'tc') - CIRCLE ONE
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: UNdCr PCNAITY Of PCTJUry' I hCTCbY CCTtif thAt I
ffi...|X ;;r#"";;""" ,n^",-,tt"*r-*." n-.t" t. correct and I swear that any infotmation which may hereafter be given by me in hearings before the
i -- r -^-'^^! | ^-6a +^ -^--1.' *,:rh oll Ciru reqrlations and State lawsnave feao trus aPPucauolr dru !
Planning and Zoning commis.io. o, th" citv council for th" ;ttv;?nf;'9::* t:,y:ly:i.:::::: "t.^9-":::"-::T3y"::**?:?;:,*:ffi: ill:t$: 1$#*iJffi,#:,'iff"'r1ffi;il'.'#"ll';H,#ffi;;;;;;;;;;;,".ilr*-'.rg;"g"1"p.:.h:,*al::T:T:":1"1..:p,":y:'.::t-:.:::,$3*i:i;,*?T,iilftrffiffiffitr#"TfJlHffiffiffif"f#;;;;'"-.t$;;i?i9;T:::::'::3.9'*^-i^::';-*:i:i::i:f::"::T:','5;Ti:'"norrac'
il'##t:;ffi"""#il;Tffi;;;;;;-^,6"*a. pemitvoidirnotstartedwithinlsOdays. Pemitvoidifworkstopsforl80davs
lLr tu r
DATE
/\_
Sig",
Dor
of Owner/Applicant
ptefer to be contacted by fax,91r!| o1_phone? CfucIe One
weriNrNc - surr.orNc FBnUIT MUsr BE PosrED oN coNsrRUcrIoN sITE!
Plan fees are non-refundable and are Paid in full at the time of application beginning Inuaty 1. 2(M5.
City ofRexburg's AccePtance of the plan rcview fee does not constitute Plan apprcval
xBuilding Pemii Fees arc due at time of application** #Building Pemits are void if your check does not clear**
{.
I
Building Sofety Deporfmenl
City of Rexburg
Phone: 208.372.2326
Fox: 208.359.3022
Affidavit of Legal Interest
State of Idaho
Countv of Madison
I,
Addtess
State
Berng fust duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, skip to B)
That I am the tecord ou/ner of the ptoperty descdbed on the attached, and I gtant my
pefirlsslon to:
to submit the accompanying application pertaining to that property.
B. I agtee to indemnify, defend and hold Rexburg City and its employees harmless from any
claim or liability resulting ftom any dispute as to the statements contained herin ot as to the
ownership of the property which is the subject of the application.
Dated this day of
btgnattrte
subscdbed and sworn to before me the day and vear fitst above wdtten.
Notaty Public of Idaho
Residing at:
REXBURG
Americab Family Community
CITY OF
www.rexourg.org
City
A.
My commission expires:
Building Sofety Deportmenl
Phone: 208.372.2326
Fox: 208.359.3022
Property Lines
Each site plan that is submitted to the City of Rexbug for the Building Permit process requires that property lines
are shown accurately. It is the Developer's tesponsibiJity to corectly identift on the site plan the location of these
lines in refetence to the public right-of-way, othet adjoining property lines, the street, other structures and all utility
lines. The Developet should find ptoperty pins that arc 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 identi$r property line location is with aland,srrvey. The City of
Rexbwg has aerial photos and a parcel line layet that can be checked, but they are only a tool and are not
guaranteed fot accutacy. If you want to request a copy of your lot, see the front counter at the Community
Development Department.
I have tead and understand the above requirements.
Signature
Pdnted Name
ing Sofely De
35 N. 1* E., Rexburg,Id 83440 city of Rexburg
Phone - Q08)359-3020 / Hotline - Q08)372-2344 / Fax - Q0S)359-3022
PROPERTYADDRESS ,* t d 2n"( (*'tt.
OWNER CONTACT PHONE
CITY OS
REXBURG
ab......-'--
Anerk*ls Fami$r Coumurity
OWNER EMAIL ADDRESS
Permit#
I Approved for temporary power
tr Aooroved for oermanent nower
OSTNER'S NAME
Approved for permanent power
Requircd!!!ELECTRIC.,4L
ElectricalContractor's N^. ,-)o:rt fe*z*r- gusiness *^^. -4) elu-h
taaress P,0, Br:u 4 1--// ciry-fi2--*-&tLs,t^t 3 "{-.zip-LJ?iCelI Phone Business Phone
Fax Em^rt , t1 oi^;ffi 6),' /. ' ' r-r,
(coMMERcIAL/INDUSTRIAL)Totalcostofelectticalsystem(ContractedAmount)$-
(Includa the cott of nateiab irtalled rgndler of tbe pa@ :uppfingit. TheJeet itted i;der tb* inrpection 4pe falt app! to an1 and all electrieal
not tpcifca@ nentioned ekewhere on tb*fonz).
E Up to $10,000 (total cost of system x 0.02) + 60 = $tr Between $10,001 - $100,000 ( (total cost of svstem - 10.000) x 0.01) + g260 = g
tr Ovet $100,001 ( (total cost of system - 100.000) x 0.005) + g1,160 = g
Small Wotks (Conttactors ONLY): $10 fee for work not exceeding $200 in cost and not involving a change in
service connections. Does NOT requke inspection.
RESIDENTIAL
Ncw: Siaglc Faaily Dwclliag, iacludiag aII buildiags with vzidag bciag coasaacbd oa cach ptopcny. (Bascd oa liuiag spacc,scc dcfraitioa bclow)
tr Up to 1,500 sq ft - 9130 tr 1,501 to 2,500 sq ft _ g195
tr 2,501 to 3,500 sq ft - 9260 tr 3,501 to 4,500 sq ft _ g325
tr Over 4,500 sq ft $325 plus $65 for each additional 1,000 sq ft. or portion thereof ($:ZS + ($65 x # of additional1.000 sq. ft. or oortion thereo0).
New: Multi-Faaily Dwelliag (Coaazcton OaIy)
tr Duplex Apartment 9260
tr Three or more multi-family units: $130 per building plus $65 per unir ($130 x # of buildings) + ($65 x # of units)tr Fxisting Residence, Modular, Manufactured of Mobile Homes, and Detached Shop: $65 fee plus $10 perbranch cfucuit, up to the maximum of the cotresponding sq. ft. of the building ($65 + ($10 x # branch circuits))tr Cental Heating/Coeling Systems: $65 When NOT part of new residential or HVAC permit with no additional
Wirirg
tr Spas, Hot Tubs, and Swimming Pools: 965 fee for each trip to inspectPuaps-Watct, Inigatioa, Scwage (cach aoat)
I $65 up to 25HP r$95 - 26 to 200Hp n9130 over 200 Hp
MISCELI-ANEOUS
o Temporary Consttuction Services ONLY: 200 mp or less, one location (for a period not to exceed 1 year) - $65
D Temporary A,rnusement $65 fee plus $10 per ride, concession or generator
I Irigation Machine: $65 for centet pivot plus $10 per tower of drive motor
n Technical Service: 965 per hour
n Plan Check $65 per hour
tr Requested Inspection: $65*Living Space - space within a dwelling unit intended for human habitation which may reasonably 16 grilizsd for sleeping, eating, cooking,bathing, washing, tytteatott, and sanitation purposes. An unfinished basement is considered pari of the living space.
Contractor
e/e-c- 73/Zc/ /
' 'a'/J /* z/^t z
License number & exp. date Date
35 N. 1s E,., Rexburg, Id 83440
OV/NIERS NAME T^i'I,TI,' LO'C
PROPERTYADDRESS iill^^n^;E t'iil^s(' Permit#
Watet Metet QuantitY:
Building Sofety DePqrlmenl
City of Rexbutg
*****r***,r****\f,/x1s1 Meter size:
cl f Y
REXBURG.. . c\r-
Anen cai Fhfrily Con ntuni tY
- t'?l lX\'{\9-'t{ l )ll / Hotlrne -
Requircdlll Plumbing
Plumbingcontractor's N^ . Jeff''y Fyf L -g'sinessName
taar.r" Qc P'av Ll tG citv--l1Ex-bl4S--
- l.\lI (r\l€*N ot I ( tL' w\t'rt)s
Rexbrrs sr^r. 1C. zip.*3a'lt
cellPhone ktt- 3t7' ilTC> b:sinessPhone
Fax
I tr-'!1-
(COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (ContractedAmount) $ 7)L/
ttt^. +^ --^, --) -11 ^1.'-L;-.
lnchdu the co$ of nania6 installed regmllest ofihe parE :uppfinglt. itttiu litniunier thh inspution We thatt appb to an1 and allp
not stecificalh nenlioned ekewhere on lhtlonn).' '{ "Up to $10,000 (@tal cost of system x 0'02) + 60 = $
D Between $10,001- $100,000 ( (total cost of system - 10.000) x 0.01) + $260 = $
I over $100,001 ( (total cost of system - 100.000) x 0.005) + $1,160 = $
RESIDENTIAL
Newz Siagle Faaily Dwelliag, iacluding aII buitdiogs with wfuing bcing constttctcd oa cach prcpetty. (*Bascd on liuiag specc,
scc dcfraitioa below)
tr Up to 1,500 sq ft - $130
a 2,50t to 3,500 sq ft - $260
tr Ovet 4,500 sq ft $325 plus $65 for each additional
1.000 sq. ft. or Portion thereo0).
New: Multi-Faaily Dwelliag (Coatacton OaIy)
n Duplex Apartment $260
I Three or more multi-family units: g130 per building plus $65 per unit ($130 x #-of buildings) + ($65 x # of units)
tr Existing Residence, and Detached Shop: $65 fee plus $10 per fixtue up to the maximum of the corresponding
sq. ft. of the building ($65 + ($10 x # of fixtures))
I Gtay Water SYstems: $1i10
tr Lawn Sprinklets/Backflow Device: $65
D Modulat, Manufactured ot Mobile flomes: $65 for sewer and water stub connections
tr Multipurpose Fire Sprinkler and Domestic Watet Supply System: $65 fee or $4 per sprinkler head, whichevet
is greater
Scwet& W'atct
tr $38 Sewer Line l$38 Water Line n$65 Sewer & \Water- if inspected at the same trme
I $65 Sewer turnaround under house (change from septic to city)
MISCELLANEOUS
I Plan Check $65 Perhout
tr TechnicalService: $65 Perhour
D Gas Line: $65
! Water Heatet RePlacement $65
tr Requested InsPection: $65
tr Hydtonic Heating: $65 + ($10 x # of manifolds/zones)
*Living Space - space wrthin a dwelling unit intended for human habitation which may reasonably be utilized for sleeping, eating, cooking
bathini, washing,^recreation, and sanitation purposes. An unfinished basement is considered part of the living space'
/X,v'l /-q-/j
Contractor License number &date
tr 1,501 to 2,500 sq ft - $195
I 3,501 to 4,500 sq ft - $325
1,000 sq ft. or portion thereof ($3zS + ($65 x # of additional
of
Building Sofely Depqrlmenl
www.rexDurg.org
City of Rexburg
Phone: 208.372.2326
Fox: 208.359.3022
Business Application Questionaire
(fot the pulpose of wastewater permitting)
sTill this business be doing any rype of food preparation or cooking?
CITY OF
REXBURG
Am e i cal Family Commun it1
1..
2.
Type of business or establishment?
t
3.SThat type of food preparatton or cooking will be done?
4.
5.
6.
lrltq1'.i L-nf du, r r-i ia( At
Will there be any deep fat frying? Yes_ No k
-$fill the facility have food disposal systems?
Are you a business planning to occupy an existing building? l*:ot, Lte you designing a new facility? ^ "o
$7ill your business have chemical storage? €9
(lter',"J'Uhano
Will this facrhq operate year rounO, 9
will there be any grease traps or sumps at the faciJity? @ir_fd1- x"
$7ill there be any types of chemicals used at this facility, other than household
cleaning solutions? Yes
11..Is there any manufacturing of products at this facility? yes
lu -t'( -l L
Date
8.
9.
10.
Applicant Signature
BuildirigSofety Deportmenl
35N I'tE Phone: 208.372.2326
Fox: 208.359.3022 City of RexburgtD 83440 www.rexburg.org
OSTNER'S NAME
PROPERTY ADDRE,SS
SUBDTVISION
PHASE LOT-BLOCK-
Permit#
Requircd!!!Plumbing
Plumbing Contractor's Name
Address City State Zio
Cell Phone () Business Phone (
Fax (
(COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (ConttactedAmount) $
(nckdu the co$ of materialt in$alled regardless of the par4t sapp jing it. The fees listed undzr th* inspection fpe shall applt to anjt and a// p
not Qecifcall1t nentioned elrcwhere on thhfonz).
! Up to $10,000 (total cost of system x 0.02) + 60 = $
! Between $10,001 - $100,000 ( (total cost of system - 10,000) x 0.01) + g260 = g
! Over $100,001 ( (total cost of system - 100.000) x 0.005) + g1,160 = g
RESIDENTIAL
New: Single Fatnily Dwelling, including aII buildings with widng being constucted on each ptopetty. (*Based on liuing space,
see definition below)
tr Up to 1,500 sq ft - $130
n 2,501, to 3,500 sq ft - $260
tr Over 4,500 sq ft $325 plus $65 for each additional
1.000 sq. ft. or oortion thereofl).
New: Multi-Family Dwelling (Conttactots OnIy)
! Duplex Apatment 9260
n Thtee or more multi-family units: $130 per building plus $65 per unit ($130 x # of buildings) + ($65 x # of units)
tr Existing Residence, and Detached Shop: $65 fee plus $10 per fixture up to the maximum of the corresponding
sq. ft. of the building ($65 + ($10 x # of fixtues))
! Gray Watet Systems: gf,l0
tr Lawn Sprinklers/Backflow Device: 965
tr Modulat, Manufactuted or Mobile Flomes: $65 for sewer and water stub connections
! Multipurpose Fire Sprinklet and Domestic Water Supply System: $65 fee or g4 per sprinkler head, whichever
ls greatef
Sewet & Water
tr $38 Sewer Line l$38 Water Line l$65 Sewer & Water- if inspected at the same time
! $65 Sewer turnaround under house (change from septic to ciry)
MISCELLANEOUS
! Plan Check $65 perhour
! Technical Service: $65 per hour
D Gas Line: $65
! Water Fleater Replacement: $65
! Requested Inspection: $65
o Hydronic Heating: $65 + ($10 x # of manifolds/zones)
*Living Space - space within a dwelling unit intended fot human habitation which may reasonably be u 'lized for sleeping, eating, cooking
bathing, washing, recreadon, and sanitation purposes. An unfinished basement is considered part of the living space.
Signature of Licensed Contractor License number & Exp. date Date
Business Name
! 1,501 to 2,500 sq ft - 9195
tr 3,501 to 4,500 sq ft - 9325
1,000 sq ft. or portion thereof ($325 + (965 x # of additional
Building SofetY DePqrtment
CitY of Rexburg
Phone: 208.372.2341
Fox: 208.359.3022
CITY OF
REXBURG(\' --"*---'
America\ FumilY CommunitY
www.rexDurg.org
OWNER'S NAME
PROPE,RTY ADDRE,SS Permit#
SUBDIVISION
PHASE LOT
Requircd!!!Mechanical
Mechanical Contractot's Name Business Name
Addtess City state-ZiP
cellPhone( )- BusinessPhone( )
Fax ( ) Email
(COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (ConttactedAmount) $----.-
(nctafus the cost of mateiah instalktl regardkr 4in, pyt. tappling it' inr Pu kteiunfut this inspection rype thatl Ep! to an1 and all muhanical
inttallations not specifica@ mentioned ekewhere on tbitfonz)
tr Uf t" $1"0,000 (Iotal cost of system x 0'02) + 60 = $
trBetween$10'001.$100'000((totalcostofsystem_10.000)x0.01)+$260=$
!ovet$100,001((Iotalcostofsystem-100.000)x0.005)+$1,160=$
RESIDENTIAL
New: single Family Dwelling, including aII buitdings with wbing being constructed on each propetty' (*Based on liuing space'
see definition below)
trUpto1,500sqft-$130n1'501to2'500sqft-$195
il2,501to3,500sqft-$260!3'501to4'500sqft-fi325
tr over 4,500 sq ft'$325 plus $65 for each additional 1'000 sq ft. or pottion thereof
($:25 + ($65 x # of additional 1.000 sq. ft. or portion thereoD).
New: Multi-Famity Dwelling (Conttactots OnIy)
n Duplex Apartment $260
! Three or more multi-family units: $130 per building ptus $65 per unit:
;:;#;iil;;;;;fi;il;;il""'r.ctured oi Mobite Ho-"" and Detached shop: $65 ree plus $10 per
1. r, r ^l- ^ L--:ll:.^^xxHVAC equipment being instjled up to the maximum of the corresponding sq' ft. of the building
($65 + ($10 x # of fixtures))
MISCELI-ANEOUS
tr Plan Check. $65 Perhour
tr Technical Service: $65 Per hour
tr Gas Line: $65
! Vater Heater RePlacement $65
n Requested InsPection: $65
! Fiteplace/Solid Fuel Burning Appliance: $65 per inspection
*Li..irg space - space wrthin a dwelling unit intended for human habitation which may teasorrably be utilized for sleeping, eating' cooking'
bathing, washing, recreadon, and sanitation puq)oses. An unfinished basement is considered part of the living space'
xxEx#ples of frVAC Equipment-furnace replacement, solar, water heatet, etc'
Sigflature of Licensed Contractor License number & ExP. date Date
35 N. 1,t E., Rexburg, Id 83,+40
Phone - Q08)359-3020 / Hotline - Q08)372-2344 /Fax- Q08)359-3022
Builehg Sofefy Deportmeil
City of Rexburg
CITY OF
REXBURG
c\'--..'..' -- - -
Ameri ca\ Familv Communi ty
OWNER'S NAME
PROPE,RTY ADDRESS Permit#
SUBDTVISION
PHASE,LOT BLOCK
Electrical Contractor's Name
Address
Required!!!ELECTRICAL
Business Name
State Zip
Cell Phone (Business Phone (
Fax (
(COMMERCIAL/INDUSTRIAL) Total cost of electrical system (ConttactedAmount) $
(nchfut the cost of materiah inttalled regardler of the pa@ sappfiingit. Tbefees k$ed anfr this intpution lpe sball app! to an1 and all electical installationt
not specifcal! mentioned elsewhere on thbfonz).
tr Up to $10,000 (total cost of system x 0.02) + 60 = $
u Between $10,001 - $100,000 ( (Jotal cost of system - 10.000) x 0'01) + $260 = $
tr Over $100,001 ( (total cost of system - 100.000) x 0.005) + $1,160 = $
Small Wotks (Contractors ONL\): $10 fee for work not exceeding $200 in cost and not involving a change in
sewice connecdons. Does NOT tequire inspection.
RESIDENTIAL
New: Single Family Dwelling, including aII buildings with witing being consttucted on each propetty. (*Based on liuing space'
see definition below)
City
n Up to 1,500 sq ft - $130
! 2,501 to 3,500 sq ft - $260
tr 1,501 to 2,500 sq ft - $195
tr 3,501 to 4,500 sq ft - $325
tr Over 4,500 sq ft $325 plus $65 for each additional 1,000 sq ft. or pottion thereof ($325 + ($65 x # of additional
1,000 sq. ft. or portion thereoO).
New: Multi-Family Dwelling (Contactots Ottly)
n Duplex Apartment $260
! Three or mote multi-family units: $130 per building plus $65 per unit: ($130 x # of buildings) + ($65 x # of units)
tr Existing Residence, Modular, Manufactuted of Mobile Flomes, and Detached Shop: $65 fee plus $10 pet
branch circuit, up to the maximum of the cotresponding sq. ft. of the building ($65 + ($10 x # branch cfucuits))
! Central Heating/Cooling Systems: $65 When NOT part of new tesidential ot FIVAC permit with no additional
Wiring
n Spas, Hot Tubs, and Swimming Pools: $65 fee fot each trip to inspect
Pwnps-Watet, frigation, Sewage (each motot)
tr $65 up to 25HP
MISCELI-ANEOUS
n$95 - 26 to 200HP l$130 over 200 HP
tr Temporary Consfiuction Seryices ONLY: 200 amp ot less, one location (for a period not to exceed 1 yeat) - $65
! Temporary Arnusement: $65 fee plus $10 per ride, concession or generator
! Irtigation Machine: $65 for center pivot plus $10 per tower of drive motor
tr Technical Service: $65 per hour
D Plan Check $65 per hour
! Requested Inspection: $65
*Living Space - space within a dwelling unit intended for human habitation which may teasonably be utilized for sleeping, eating, cooking,
bathing, washing, tecreation, and sanitation pu{poses. An unfinished basement is considered part of the living space.
of Licensed Contractor License number & exp. date Date
BEXBJA,,G_
Am e ri c ab Fam i lY C o mm u ni tY
Street Address Whete Work Will Be Done:
Business Name Vhete Wotk Will Be Done:
Dates for Work to Be Done:To
Contact Petson:
Phone Numbet:Cell #
Requircd!!!FIRE SPRINKI-ER
Fire Sprinkler Contractor's Name:
Business Name
Address Clty state--ZiP
Cell Phone () Business Phone (
I
Fax
(COMMERCIAL/INDUSTRIAL) Total cost of fire sprinkler system (conffacted Amount)
$_
(ncludes the cost of rnaterials installed regardless of the pa@ suPPbng it !h.efee1 listed under this inspection Ape'shalt
Ep[t to an1 and ailfre alarrn insntkfions not specficalfi rzentioned elsewhere on thisfotrn).
! Up to $10'000
! Between $10'001- $100'000
n Over $100'001
MISCELI.ANEOUS
n Existing InsPection Base:
! Re- InsPection: $65 Per triP
(-total cost of system x 0.02) + 60 = $
( (total cost of system - 10,000) x 0.01) + $260 = !
( (total cost of system - 100,000) x 0.005) + $1,160 = $
$ao
n New construction $l per sprinkler head ($2'000 maximum)number head
ture of Licensed Contractor License number & exP. date Date
Bui Sofely Deporlme
35 N. 1,t E., Rexburg, Id 83440
Phone - Q08)359-3020 / Hotline - Q08)372-2344 / Fax - QOg)359-3022
LOCATION OF WORKTO BE DONE:
Street Address Where Work Vill Be Done:
Business Name Where Work Will Be Done:
Dates for Work to Be Done:
Contact Person:
To
City of Rexburg REXgUBa
Americq's Fomilv Cnmmuni ty
Phone Number: ( )Cell#( )
Requircd!!!FIREAIARM
Fire Alarm Contractor's Name
Business Name
Address City State_Zip
Cell Phone () Business Phone (
Fax( )\-
(COMMERCIAL/INDUSTRIAL) Total cost of fire alarm system (Contracted Amount)
$
(ncludu the cost of mateiak installed regardless of the panjt suppbing it The fees listed under this inspection Apeshall app! to an-y and allfre alamr installations not specfica$t mentioned elsewhere on thisforw).
! Up to $101000 (total cost of system x 0.02) + 60 = $u Between $10'001 - $100,000 ( (total cost of system - 10.000) x 0.01) + g260 = g
n Over $100,001 ( (total cost of system - 100,000) x 0.005) + g1,160 = g
MISCELLANEOUS
n Plan Review per Hour: $65 per hour
n Re- Inspection: $65 per trip
ture of Licensed Contractor License number & exp. date Date
a-
SUBCONTRACTOR LIST
Excavad.on & Earthwork:
Concrete:
Masonry:
Roofing:
Insulation:
Dtywall:
Painti
Floot
Coverings:
Plumbing:
Heating:
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses;
Floot/CeilingJoists:
Siding/Extedor Trim:
Othet:
E,XE,MPTI
o
ONS FROM STATE, RE TRATION
As ofJanuary 1,2006, the City of Rexburg can no longet sell permits without having a copy of your State
regisftation number or.your exemption from the State tegistration. Please send a."py "f y"* state registration or
fill out this fotm showing yorr exemption and send it with your license renewal o. yo* next permit ap-plication.
(fhis list is a summarization of Idaho Code Title 54 Chaptet 5205, fot firll definitions of these exemptions please
see the State's website at www.ibol.idaho.gov/cont.htm)
tr currently State licensed pursuant to Title 54 Idaho code, chapters:
3 Architects,
1 0 Electrical Contractors/Joumeyman,
1 2 Engineers/Surveyors,
19 Public \Works Conftactors (exempt from fee only registration required),
26 Plumbing/Plumbers,
45 Public \Works Construction Management Licensing Act (exempt from fee only registation required), or
50 Installation of heating, ventilation and at conditioning systems
tr Employee or volunteet of a licensed contractot or part of an educational curriculum or nonprofit chadtable
acivtty with no wages or salary
tr Employee of a US Govemment agency (State, City, County, or other municipality)
tr Public Utility doing construction, maintenance, or development to its own business
tr Involved with gas, oil or mineral operations
tr Supplier doing no installation or fabdcating
tr contracting a project or proiects with a total cost less than $2000
D Operation of a farm or tanch or construction of agricultue buildings exempt from Idaho Building Code
tr Any type of water district operations
tr Wotk in rural districts for fre prevention putposes
tr Owner who perfotms work on own propefty or contracts with a registered contractor to do work as long as
the propetty is not for resale within 12 months
tr Owner ot lessee of commercial propety perfotming maintenance, repair, alteration or construction on that
propefty
Real estate licensee/property mafla;get acting within Idaho Code
Engagrng in the logging industry
Rentet working on the property where they live with the property owners approval
Construction of a building used fot industrial chemical processing per ldaho-Code
Construction of a modular building (defined by Idaho Code) to be moved out of state
I hereby certiSr that the above information is true and corect to the best of my knowledge.
Signature
Pdnt Name
o
GIS
tr
tr
tr
fl
tr
o?
WARNING!
IF YOUR BIJILDING OR SIGN IS $ruTI{IN
1 5' Vtr,RTICALLY, DIAGONALLY, OR
HORIZONTALLY FROM AN OVERHEAD
PO$rE,RLINE, YOU MUST CONTACT
VINCE AT ROCKY MOUNTAIN POSTER.
(208) 3se-4272.
BEF'ORE YOU DIG F'ORANYTI{ING Btr,
SURE TO CALL DIGLINE, AT 1-BOO-342-1585.
IF ATANYTIMtr, E,XCAVATION IS
REQUIRE,D IN CITY RIGI{T-OF-S7AY, AN
E,XCAVATION PERMIT IS REQUIRE,D. YOU
CAN OBTAIN AN E,XCAVATION PERMIT
AT CITY HALL 35 N 1ST tr,AST.
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Duke Manufacturing
"Your Soluti,onr Pertncr"
E3O3SW Item#:2
Approval Slarnp{s}:
PSOJECI I ilFORhIATI OtI;
PRO,JICT
tTIh4
OUAIiTI;Y
ilOOEL:
Aerohot $teamlables
Hot Food Units - Electtic - Sealed Wells
Specifications
f 0B Srdali: ld;ssauri6530'l
E8A28W/EP302EW
HAgSWEPililSSW
HA48W/EPgA4SW
E3058W/EP3058W
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17 aossns
J Sfi,;ifl,] shill/e5 - k *-.460-is
Ghss riirlar $rlr,es - Itr
Sh:l,.'estCirirni b $rqs . tt(t -x8/412-x8/iltlti-x$
Biirei :hel',r*i " 63tt/7 9xFWlxilLl7ilrtlTl&Ixl
99rFU88x8W?tHT
Acapirr pla:es - 3l, 92, 33
ir''sel1rin\r' Lt,+rs - 521, 522, 523
Trltsrolr :n,rlr,s- 546, f48Tubular lrar slrors " 08TS-FX-x/H0-x
Sniflage pa'r"s - 576, 676
ASTTICY LISTI}IG8:
g,@*.'*
OUI(E MA}IUFACTURING CO.
230$ il. Broadway
$1. louis, M0 63102
800.735.3853 Toll Free
314.231,1130 In Missouri
314.231.5074 Fax
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t-x8/956-xS1956-
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HEAT COMPTETMEIiTS:
I 5.;,rltss -iiill iir.:::r:: t- 1ll Ce:p r;al;i trell
I lnii.,:-ai }l9ll $iairs l:u t.iir "al'r:5I ,!qi ,"'," c'-r L,se
I $irll; gig5;1 516a,J3p;
BOOY. U'IOERSHELT A}ID [EGS:
I 2i galg: .13! Serie-< ii;'nliss stael bnc;
I '1 I gaL;i rlil Sefie5 5is,nh:s sltfl urriersreli
I .1:0 Sin:s slairless sii:i iuh;lar ltqs Jrll'r id usi'h,l !le-r:r;: {tt1
ELECTFICAL lllF0BfillTl0H:
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f, ,J1,'t:tC ii ,liirAie Br ::r-r -rrg ff 2,1,: i,.+11
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SHORI TORM $PECIFICATIOI{S:
Iluke Aerohot Steamtables - Hol Foorl - Electrlc - Sealed
lllells irf snall 0r nra:l ;a]p 30[ 511].ri :]liinlq5:i sircl ririlr brly.
:-iriiiriitaia ,?nd lri5 icrmN: r{ l;:t'ii'qarq: {ll Sfries slainlfSl tiril lop 1.r'
h3\,ri,litr-sl?i-:[it tlrni1l5 Tf;5Ji n3 i?-1i]t i ]C'tl16 i';ilr b-]11 C,:t!',
lial..d r,*i! *rlr lll' nrairr !,r:1i $hale slarJiri liah iom!3rtrinl 11: i;,it
150 r;;il ql:i!:ri filierj unr.j:: !';a"nlt0 iOrlarlrtnl [tii: sqil$ nCl r0*C
rr'rli tc, ha.e inJi,r'J,.;al drai'r :al:,1 I'firei lc:13'ai. on 12ii. iit ot 140 r.'cil
5lnqle ,r 3-cla:'i AC turietrl ?r *rderrd [:lh 5ac1]0n lg c* ;f'titollqC b't
irfrn,ies.,;ril: lersrantnliini.:i 61C1,0;0rgyrithflUgpro!i0pd JniislXip
igrnrshtl /;ril{,,-1li iarh0nsii -ir,',r-:! b0arJ n,:rsrrlnq l'r 1.i.lni:h r'rith 1E
JeuEi liai,rla!s llrfl supFt:l iitrr and ,if-:irnxtl lra;kels p*riaill'; un,l5 l0
ri,!,i i.;5! lriilI irsir,t 5 {;,jiri'r rubb::: Elnii.l-iJpi. ll,i fl,ii] lucls.,tll
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Duke Manufacturing E3O3SW
FRONT VIEW
0l$ltil$|0ilS; ii-];irlull fal0rf br 3.chase ll*,-'irr;;t tqufeninls ,|1i riifr cpiii]. j
Model i[.
I t30zlEP302 30-3r!
E303/8P303 44-3''l
E304/EPt{14 tt..i :
Item#:2
AEBO}IOT STEAI{TIILES
HoT t000 ulllrs - ELECTRIC - SEALEo U,ELLS
E302SW/EP302SW i;-trr-'r;rj:
ESA]SW/EHAfi$W i!:,r,op:r1inJs
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RIGHT SIDE VIEW
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lrvatlslAmpsitlEMA Watts Amps r NEMA Watls I Amps l{EfilA
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OUKE MA}IUFACTURITIG CO"
2305 H. Eroadway
$1. Louir, ft|0 63102
000.79t.3853To11 Froo
31{.231.11311 In Missouri
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