HomeMy WebLinkAboutAPPLICATIONS, BP - 07-00308 - 820 Yost St - New SFRi
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CITY OF KEXB UKG
BUILDING PERMIT APPLICATION
19 E AL1IN, REXBliRG, ID. 83440
208-3�)-3020.X326
PARCEL NUMBER.'
P'F,R NV IT #
Please
Ifthequ
07 003.08
s.�
0S11 St -Andrews
SUBDIVISTON:
(Addressing fs basedonthe
-must be accurate)
WNER
NAME:
6-
PROPER'1'I' <°1DDRFSS:J
UNIT# BLOC]<# LOT#- J5—
rrivl�t, �7:
1.40me (an�)'3s%-O`ya
Work
o%VExNMAILING ADDRESS. yy
0 Po���� r
En�UL C_ v py�l,�, ct,�..
C 0 N TLN C P H 0 -N 74
I
3S 1-:�y�5
� L Yasfi s1:)
Cell
01
���> CITY. (��,r�u<�-
STATE: j2) ZIP:83yya
FAX C6qa
APPLICANT (If other than o_\vner)�#
W11
(Applicant if (->ther than owner, a staternent authorIzing app cant to act as ao-ent ffir wrier must a ccOl ITanY this application.'
b
APPI.JCANT INPOItiIIA'I'ION: ADDRESS CITY:
STATE; ZIP ENLAIL FA ",V
PHONE #: Home Work
( ) Cell ( )
CONTRACTOR.
MAILING. ADDRESS: -CITY S
PHONE #. I Iome VT
.__i.
TATE ZIP
IDAHO REGISTRATION # & EXP. DATE
Bow rnuiv buildin.g� are located oia this� ..,�
rry
•
Did yourecendypurchase thirNo QLe�)Tfyes
tv e owner's name) Ur'
g L
Is this a l t s llt?
YES Please brinT
Co of n N_�
g y gal description of property)
Alkf
PROPOSED USE: Fo %IV
(i.e., Singie Familv Residence, iLlulti Fa .1.1Ap-a
rtments, Rem odel, Garage, Coxo unercial., Addidon, Etc.)
APPLICANT'S SIG -NATURE, CERTIFICATION THORJZATION: Under cnalt-vofper'ury, !hereby certify
that I have read this application and state that ffieinforination 1-1,re
he-ai-ings before -I is correct and I swear that any information wbic-1, in.,jy hereafter be SqV
ssiion or the CitY Council for the City of Rexburg shall be trtithftil and correct. I a9fee to comply With all
the Plannmig an(i ZoIllifig Commi, en by me In
City regulations and State laws relating to the subject matter of this appEcation and hereby authortzed representatives of the City to enter upo
mentioned property for inspect'0118- purposes. NOTE: The building offidal may revoke a permit on approval issued Lmder the •provil' n the above -
International Codcm' ca-scsi ofany false statement or im'srepresentation of fact in tlic application of (in t1le plans on wh'ch the perm' 41ons of the 20,03
b ased, Fermi t void I f no s t a-rtcd with in 18 0 days. P erg v 'd if work s top S for 18 0 J it or approval was
ol
J
Signature of 0wnke_'r'/Apphcant
Do y0rto be contacted by fax, email or phone?. Cll:cle One
WARNING — BUILDING PERMIT MUST BE POSTED ON CONSTR fl S1
I w 2007
Plan fees are non-refundable and an full
re paid iat the time oapplication, 'f b egin e
9 g ar
City of Rexburg's Acceptance of the plan ri
eNriew fee does not constitute Ian, ap rovat l
**Buildiixg Permit Fees are due at time of application** **Buildingr Pem'
r
its are voi
'd i w C doUnot deaf**
C1W OF REXBURG
t
Please complete the entire Application!
(et'vNANIEl'AV,uw�Gls
PROPERTY ADDRESS Perrnit#
SUBDIVISION h-eL4d-eYPC'0,,, 6,1r K S lit 3S'
Dwefling;
Parcel Acres;
SETBACKS
FRONT s' SIDE L% SIDE (n
Remodeling Your Bur'1dr'ng/Homme (need Estimate-)
SURFACE SQUARE FOOTAGE: S_h=all'indude'
the exte.riox wall measurements of the building)
Fest Floor Area
Second fioor/ioft area
Third floor/loft area
Stied or Barn
Mg
Unfim',%_;hed Basement area Y.
Finished ba. ment area
Garage area I.-
Carport/Deck (3U')
above gride)-Area
Water Meter Quantity: * **** * *****Water Meter Size: . )/'j k�
I?equrred.!!f
PLUMBfNG
Plutiabing Contractor2s Name:
w
4
Business Name-, tm. A ( 6,.n,
A d dr e ss I/,,-�ij ��QC��f- 1*�07p(,� CjnT Re2 Q Ili tate_
Contact Phone;
Business Phone:
Email.
FIXTURE COUNTfinclidrtr�; roughed , rr-,y Lux�es
Clothe;; Viashing Mact-iine
_ Dishwasher
Floar I�r�i.i1
_ Garbage Disposal
Hot Tub,/Spa
Slnk,s (Lavatories ,kticlen, bar, mOPl
Plumbing Estimate $
o f Lige .
��t
Fax
L` Sptinklers
Tub/Showers
Toilet/Urinal
Water Heater
�VatcrSoftener
(COMMERCIAL/MULTI-FAMILY ONLI�
License Number& E_ s t n Date
' �yof ., + j- ei �� - c scbedifle is The saizie as re
quired
Y Me Stwe qf Idah 0
Date
zip_C3440
4
0
2'
Phase complete the entire Application!
NAME VIA -et- ovk
.............
PROPERn7ADDRE-SS Pe-tnut#
SUBDNISION
* 0 r�RqE�dVMc�caL -
klechanical Contractor's Name
Address r�.� t``i',
Cell Phone (��4�) ���C � �•�
City.,
CV,
j
.Business, Phone
Fax ( Email
Mechanical Estimate $
Business Nees
C4
(Commercial/ Multi Family Only)
State Zi
56 -
FIXTURES &APPLIANCES COUNT (Single FdmilyDweBii�g Only)
1 --Furnace
Furnace/Air Conditioner Cotnbo
.�.� Heat Pump
Air Conditioner
Evaporative Cooler
T h
r t Heater
Space f leater
Decorativ, e gas --fired appliance
_ Incinerator System
Boller
r�xnaust o v es
eY �'ei1tS
Rangy Hood Vents
Cook Stove Vn s
Bath Fan Ven
6
other smear ven r T t
_Pool fleater
Fuel Gas Pape �ut��t� including ~tubbed in or future outlets
In1et P-tessure (Meter Supply) PSI
Head (Circle all that app1Y)' G as Lail Coal Fireplace Electric I-lydroni
c
Me- chanical SIZI C.,alculations must be subn1itted with Plans &
Point of DefivefyFaust be shown on n1am,;_
Signature of Ucensed Contractor
License numbef
Date
X17 Of Re-.�: spermia+fie x lele is the Sal -We Sal-Weas re d/1 d b), 11j�Atte f -
driho
fi c a tio n
5
n
iff
FROM -E
FAX NO.
U24/2007 7100 Pq rA6Rt fag
--pr.
TO: 5520554 PAGE; 0"
Bui*ldsinq Safety Department
Cffy of Itexburg
F Mein j ne ffh g_ x Pbo o.— 20 3020 x-326
Clxbur , D 83440 www-rexbUt04 0 rQ Fcx 20a
ti
ALIJJ'�wS
PRC? '};R'I'1' ADDRESA1,45
SiTF31�1VI5i;�N {{tkc%.;Jso�' �-"3
FT -TA .};_�_LOT_�_._gLOCK_.,�
25 2007 07:350M pl
XXII B
Tri
WY
�f
Permit #07 00308
820 Yost St -Andrews
R,c c ru .red �!� ELECTRICAL
F
Ie(.l '(d Contracto?s N
rork
rCR 1(
Business N=ePke`!'�Cctl tl(ili�iDr/ e
rv)lc P,$
Addr s: �i/�S 'T'e ,4f ca-kvOr C1ty.21wt�o Ta��S 5iarc TD _ TiFd��
Coll 1 h Dr,c 6041 Business Phone
Fax (2.0g)SS_2 - wmmaL5. EMMIApif!c. !a7 m5isr GDS ---
Elec, rik:A Estimate (con r'ng -- MMICMIJL71-FAI
f--ONLY)
T'PP'7 OFINSTALLA '701V
(Ne if - R.--d-lidewidalincludes evur Ir
rrsidendal,%4watwe and -aedgaragr.%,t the �j p .c j;nj�)
UP to Z'-'.00 Amp Scrv'
20l to •400 arr7.p Service'.
Over 400 amp Service*
. _ }I'gym �arAi ��UfiS�.�[3C�}❑1S7 StIVICE,200}� ��m� or one lucation COE a L txot i:n- exceed f yeq.f)
K tin;; sdden�ial (# of BranchCu'xluits)
Spa, HotTub, Swimming Pool
....�_„� Hlectn'(-- Central Syswms Heating g.�7dlo�' Coolmg (,when resat pert of a nca� r��dcziti�l ins traction Pcrstiii:
�it� 17c� :i����r,�l wiring)
Moduhc--.r, tVf.anufactured or Mobile Home
C)the.r J'rjS tq 11ra L'
-any of t air a ove
Cost f �" r1 on
ILLS QOnitgtic Watcr,Sew
ag
Requested Inspections(of1 'b .
urian
Fempofftrr Arnusc-rnrmt/TndjjstrT
, r�vimx=iAddLIjond
a
red nc;pccfionrest-IrC)4 r , 1011r.
X1.7 Erg -
r Vf Li
ed Contractor
T& GAY. elf
C- PM6.
Licewc :aUrrzbT-x
gameja'C-'V?' 6UV�od
Date,
E
EXEMPT�C�l�SREGl�'I'IATIO
As of January 1, ")006, the City of Rexburg can no longer sell pexmits Without having a. copy of your State
registration number or your exel'nPtlon �rr�tn the State re stra91 tion. Please send a copy of y our state registration Or
fill out d -us form showing your exemption and send zt With your license renewal or your next pc_rmit application,
(This. list is a summarization of Idaho Code, Title :514 Chanter Cry,- f',ii -i C4 e .,
.J,;�:�___
see the State's bsite at Ax,-v7wfl-)o_1_'I n ciIi-, n (V
we
o
cont-11 LID) x__e t- aLL-Lous r r -nese exemptiolls pleLlse
El Currendy State licensed pursuant to'Titie 54 Idaho Code, Chapters:
3 Architects,,
10 Electrical Contractor�/Journeyman,
1? Engineers/Surveyors,
19 Public Works Contactors (exetnpt fxotn fee only registration reqwt
26 Piumbii�g%Plumber5, 91 -ed)
45" I'uNlic \Vorks Constaruc6c>n TManagement Llcensing Act (exenipt front fee only registration reqw're d),.or
50 InstaHation of heating, ventilation and air condItioning systems
El Employee O,r volunteer of -'a I1censed contractor or part of an educati
'Onai curricLdum or nonproffi.,,,. arita e
actiNrlty V?1th no wages or salaq-
o Elaiployee of a Lr5 Government agcncy (State, City, County,
or other municipality)
❑ Public Utility doing construction, maintenance, or development to its own busines❑ 's
Inv, olved With has, oil or Mineral operations
0 Supplier daing no installation or fabricating
r_1 Contractiiwy a projecti or projects with a total cost less than $2DC�(�11Ope-ration of a f,,-trtn or ranch or constructon of agriculture bLuldings exempt from Idaho Building Code
0 Any type of Nvater �i4trictI/ operations
El Work in rural di5tricts for fire preventionpurposes0��=i7er
who performs work on own pre}pett-y or contracts �71th a re91 stered contractor to do work a -s, tonas
the. property.i5 not for,resale within 1? 1-nonths g
❑ Owner or Lessee. of cotmnerclal property pe.rforrmng triall-iteriance, repair, alteration or construction on that
praperty
Real. estate ]iccnsce/praperty. manager acting Within Idaho Code
El Engaging in the Io .ing industry
11 Renter Nvorking on the property where they ]ive with the property owners ap roval
1:3 Construction of a buii.d�.ng used fot Industrial chemical processing per Idaho (-',(-)de
M
Construction of a modul-ar building (defined bar Idaho Code) to be moved out of state
I hereUyCerti�T t the above information'""ea,3"Vcis true and correct to the best o my knt��rledge,
U,
Signature Date,
0
Print Naine
9