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Home My WebLink AboutAPPLICATION - 06-00100 - 864 & 874 Parkside Dr - New TwinhomeCITY OF REXB UR G -� BUILDING PERMIT APPLICATION Pleas Of-�JO 100 r 19 E Marty, REXBURGiI. 83440 If the c864 & 8 74 Parkside Dr ►e 208-3-59-3020 X32 1 PARCEL NUMBER:-f—}� �' �'✓��(��y,, `�� F�.d-LI`" �� l we wiIrprovi�e this for you) SUBDIVISION:�?ar UNIT#, (Addressing lk based on the information - must be accurate) OWNER NAME : PROPERTY ADDRESS: 5z7 BLOCK4 19 LOT# CONTACT PHONE # I PHONE#: Home ( ) Work ( ) Cell ( ) OWNER MAILING ADDRESS: CITY: STATE.- ZIP0 EMAIL TAX APPLICANT If other tha ownez,) - (Applicant if ocher than owner, a statement authorizing applicant to act as agent for owner must accompany this application) APPLICANT INFORMATION: ADDRESSCITY* STATE; ZIP EMAIL FAX PHONE 4-: Ron-ip ( A ------- � � vvurx l 1 Cell ( ) CONT-RACTORO __6� MAILING ADDRESS rO_A� PHONE: �,#' god _ 3�4- o-��z W ? 401-" V_C�_4 I V11A I Li Ve.AV 1'!db7 a .- _L_ _. - L z -v_ .0-n , � A -V Haw txzanyr buildnags are located on this Property?- Did you recentiv purchase this property?0 Yes (if yes g7ve owner's name) Is this a lat split9? yEC (-rlcdse brig copy of new legal description ofra erg p � Y PROPOSED USE: (i.e., Single Family residence, . inti Family, Al CITY�'r_ovo Cei1# !� a -- a _STATE 44 ZIP01 .B�o�_ Tr4.�s� encs, Remodel, Garage, Commercial, Addition , E FEB 2 3 2006 APPLICANT'S SIGNATURE.� CERTIFICATION AND that I h v e read this applic tion an state tat the Information leer ' p� jury, I �i r bcertify 1 correct and I swear that any information Nvhich ma'\� li re . . r b given - ir,. l�ea�,ir� before thePlanning and x�� n�ia� +�r i � � rr� the .l , Council for the City of Rexburg shall be truthful with all City regulations .Tid State lees r i atir� t� � �� correct. � � � t comply subject matt r o this appli atior, and hereby authors upon the a��-rr��ati�id propertyfor inspections representatives �� i�.r t enter ons purpose . TE- Illi bulldin official ma provisions of th 2000 Int rnatlor�.al �� r pr 1 o�� a r �7 .. i u �n cases f � false statement or r i r r nt t o fat 'n t sit � �{��al ��Ta � Permit_ li:�: �- n tIn �. ��Fhi�� the Mrd if n t �4Aed within 180 days, s, r�r it �� t* P fr 180 day. F 9 Oature of O�Nrng oi(pplicant C�' / E / you rte' to be, contacted by t'hone.• it r Circle One WARNING — 13UILDING PERMIT MUST BE PO,STED ON CONSTRUCTION S T -F I Plan fees are rion-refundableand are paid in full at the tirne of application be6nnin JanuatTl,, 2005. City of Rexburg's Acceptancef the plan rig fee d ' + not rr � ' ute plan approval "'Building Permit Fees aredue at time application"; **Building Permits are void if you check does not clear** L* 'P CITY -C,,-.f U f wG /�JMLKICIVS FAMILY CONMUNrl'y State of Idaho County of Madison 13 i6cn _ Name YOVO City 4o;.vq D Affidavit of Legal Interest Being first duly swom upon oath, depose and say: ozo n 0 ao - Address fit- � �oQ� State (If Applicant is also Owner of Record, skip to B) P_Kw0 ,-7 &_ A. That I am the record owner of the property described on the attached and I brant mA7, 41 permission to: Name Address to submit the accompanying application pertaining to thatpropert�. B. agree to zndemnify, defend and hold Rexburg City and . its employees harmless from any Claim or liability resulting from any dispute as to the statements contained herein or as to the mkmershl'p of the property which is the sub" f the application. 9ect 0 Dated this a day of to, 20� ignature DrA Subscribed and or to before me the day and year first above wri itten. 0j:kA Ge a*%% IL M.W* IF NN It M .0 IL % &SEA U EIA V440r, Aj ON ho, < OF Notaily Public of Idaho R.esiciing at: fk r", - :% My commission expires.. ---,A-- � - aoca9 208359 9 B 9 Feb DO US 110*49a Parkomi.,de To i AWANCED PLUMBING riease complete the entire Application! NAMEeo , z PROPERTY Xij If the qutstion cues not apply fill"n NA for non applicable mn� & 111 * AMA Dwelling'Utifts: Parcel Acres: SETBACKS FRONT yg' _ SIDE ! S SIDE p 6ACK 36 P. Renrodeling Your,BuildinglHonfe (need Estimate) $ SURFACE SQUARE FOOTAGE.- (Shall include the exte��or wail measurements of the build'ing) FirstFloorArea Second floor/loft area��__ Thijrd floorAoft area Shed or Barn 11_� Unfinished Basement ��['ea Finished basemcnt area VAMpr Gara9c arca Tr3, Carport/Deck {3D" above gxadc)Ar'ea Water Metcr Quantity: ... --------- WlterMeterSiz Required rl! PLUMBING PlumbntgContraefor'sNam, e: Business Name:; Addtcss_LPjijy � r Conm-t Pho ne: Business Phone: (2p8), F� PAGE 03 State �. �51o32Z xrnau � vMo�wFax dox--35-f-y, /0 F` RE CQU,�' i�clud�� rau ar�d r.�t�rres CloxhcsWashing Machine -Dishwasher P 1 aor Drain Garbagc Disposal Hot Tub/spa Sink: (Lavatuncs, kitchms, bar,. mops plumbintr Estimate drr.;am�nerciai C-only� License number �Lve,vchedjde "T Perm 7! thesame Qfi I'�Q'7�!#r'i� by RbE State of Idaho signature of Licensed Contractor The City Of Rexh-��l _*_ Spdnklers 2. Tub/Showers � Toiietfurinw Water Heater ,-0-... Water Softener I lease Complete the entirc App applicable NAME GGoy PROPERTY Al SUBDIVISION 10�9 _4"N I1Cat101110 If the question does i. apply sill in NA for non Required!!! W Mechanical Contractor's Name: Address PC G(O Contact Phone: (208 ). M Permit# MECHANICAL K i eK SM ITS Business Name: JA0VAI +�k,yV L�. 9 % le,�State Zip�Z, - . � 4-6 -1 MW7c Business Phone: (7,00)_7 Email Fax /Ll'S --(R�7 (a 7 Mechanical Estimate $ isc 0 `. (Commercial/Multi Family Only) FIXTURES &APPLIANCES COUNT Furnace FumacelAir Conditioner Combo �'r Heat Pump �_ Air Conditioner '. Evaporative Cooler �-- Unit Heater Space Heater �� Decorative gas --fired appliance ,� Incinerator System -0-- Boiler (Single Family Dwelling Only) �� --�-Exhaust or -Vent Ducts Dryer Vents 771 7 Range Hood Vents Cook Stove Tents 3 Bath Fan Vents other similar vents & ducts: _�_ ._-�--� Pool Heater .. Similar fixtures or Appliances �_ Fuel Gas Pipe Outlets including stubbed in or future outlets Ix�et Pressure (Meter Supply) PSI' Heat (Circle all that apply) 6 01'1 Coal Fireplace Electric ingMechanical Szi Calculations must be submitted with Plans & Application Pvl`nf of Delivery must be shown on plans,. S ignat 'TCantractor eL 9 9 License number 7z- 66 Date The City ofRexburg:s pet'i111t_,fee schedule is the same as required by the State of1daho Excavation & Earthwork: Cmicrete: e0e, Masonry: Roofing: Insulation: Drywall: ti,/e,,, Painting:�4 Floor Coverings: Plumbih-ig: Heatingo E1ectricai ?92 SUBCONTRACTOR LIST m EMENIMME GC%eG u 0 17 mz" I �� 1,1ev -i� -- .04c— Roof Trusses: Floor/Ceiling, Joists: Siding/Exterimor Trim: Other.0 ;Z- 10 Special Construction (Manufacturer or Supplier) CITY OF REXB UR G � BUILVINGTERMIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 208-359--")'020 X322 PARCEL NUMBER: �t Please ct If the questi 864 & 874 Parkside Dr We ` win provide this toy' youY 0 V% 19 SUBDIVISION. " 4 A UNIT4 $Loci # (Addressing is based on the information - must be accurate) LOT# 5 OWNER NAME: CONTACT PHONE # `7 10 D — O PROPERTY ADDRESS: PHONE #: 1-Iome ( ) Work ( ) Cell ( ) OWNER MAILING ADDRESS: CITY: STATE: ZIP: EMAIL FAX APPLICANT (If other than owner) (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS STATE; PHONE #: Home C u1v (LGgC'TOR: MAILING ADDRESS: x)11 C.C. PHONE: fie# &off-a7y-o�7zWork# EM19IL�V4LY �; d 4v64j,_i komes FAX toss CITY: ZIP EMAIL FAX Work ( ) Cell ( ) f CITY 4�eovo CeI14._ 76D -o185 d J STATE_ UIL ZIP�y_p-_ K5ql -%Sin[h On 12C E- - qC0 �iow many buildings are 5ocated on this property? Did you recently purchase this property?slyes (If yes give owner's name Is this a dot split YES (Please bring copy of new legal description of roe � s PROPOSED USE. Lotc s11111CP l i.e., Sixlcyle Family Residence, kulti Family, Apa ent�, Remodel, Garage, Commercial, Addition, APPLICANUS SIGNATURE9 CERTIFICATION AND AUT ORJ A J n d c that I have read t i. 1 p1' ate n mid statethat ti forma � n herein is correct and I swear that any information In hearings before the Planning and n in i T. � .Y �- ti ��.i� fir t�� F f .��u�`� �1 with X11 A\, regulations i-�d Statelaws � � � truthful rte correct. I �i � �� relating t the �� j t matter f this heat' � � _ � upon the bov-inention r _ erg Tfor a rebs} authorized d r r nt ative s ofth City to eater The provisions f t�. International �ses any �1 revoke pen -nit rY rissued under t1� Tit or a roVal wasba-sed. . alse statement or rnisrepresentat] f fact i theapplication r n the fans �� wh1 h the Permit void ��' not started ��t��r� � ��r. ��r�lt Id if work stops for 180 d . 519nature of ON)gVA.pplicaiit 4 to"11-i L)o you preler to be contacted by fax, eniail WARNING — BUILDfNG PERMIT MUST BE POSTED ON CONSTRUCTION Plan feesare non-refundable and are paid in full at the time of� �t tiro beginning 2005. burl a tare oft the plan review fee does not corp ltute plan approval'Building Permit Fees are t due at time of pli fion** **Btjilding Permits are void if v u check does not clear" A6. IF FAi 00 CITY Of- f.Z�.EXBUR..G. State of Idaho Coun�T of Madison Name W it �' L Affidavit of Legal Interest Being first duly sworn upon oath, depose and smj: A;2-30 WIL Address State 9 (If Applicant is also Owner of Record, skip to B) 0 �514 L,;. A riI To IIIIIIIIIIIIIIIIIIIIIillillilillillilI -- A. That J am the record owner of the property described on the attached, and I brant nay perniission to: Name Address to submit the accompanying application pertaining to that property. B. I agree to indemnify, defend and hold Rexburg City and its employees harmless, from any Claim or liabifity resulting from any dispute as to the statements contained herein or as to the ownership of the property which is the subject of the applicaiion. Dated this day of 1,: � � 20 n(� Signature Subscribed and sworn to before me the day and year first above written. Notary Public of Idaho Residingt: My � commission explreSr 7 ,7 i s oa oc 11&20010 6gL�� E P es�aa�seee re:3e 59930J3193 M� . - M 1 0- %O%JW I U W 3j 2uli3b� I'l I deb 08 alb ,-son Perk''"�le PAGE' 02 *Mac -� a ,�1C�SE romplete the entire Application ! If the questi"ou does not spp1y fill ua NA for non applicable li��illillililili rv^Mr: C7C r W n aeyAa_U Merl-� PROPERTY AD6RE.SS S&14 W, � SUBDIVISION Dwell r Acres.4 PmrMl'.t1i SETBACKS FRONT 78' SIDE $` SIDE �3 RACK 36 Remodeling Your RuildinglHome (need Estimate) S SUR -FACE SQIJARE FOOTAGE-- (Shall include theexte°rivr Wall measuremen.m Of the building) First Floor Area I Sccond floor/loff area $ Third floor/loftShed ter Barn— Unfirished 13asement area�� Finished basement.-are�-7 Ciarage area CaToft&*ck (3 Water Meter+' Quantity - Water Meter Size* J?eqU1"redf!! PLUMBING Plumbing Contractor's Name# 4Y�P Address I241 DGVt 12oG1� tX. M city Businu.is Name; Contact phone: 009). --0.32 2 Business Plione: (Poso-%/ -4 .0-0. Email A. fax FIXTUREFhed,rxtttrec� _ Clothes Wasbing Machine Dishwaiher Floor Drain Garbage Dispos.ftl $-' HST Tub/Spa Sinks _. T - (Lavatories, kitchens, bar, maps ,Flurobiag Estihnate $ (Commerctal Onhr) Signature of LicensedConn-actor 777&0� f Rex burg �,5 .-, -itt it 1, Pep, Licence nurnbeT a o g - 3sv- ? Spr)*.nkJe,,rs J,- Tub/Showers ToRcVUrin.al Water teeter Water Softem ner 12" Date aired by1hg S1019 c,, f Ida ho t U 4 -- Please complete the entire Application! If the quest'lon goes 1.,.04. apply fillin NA for non applicable NAME (SGo r c,�-w n VPROPERTY AD-dRES S 8100 ar k.n: lie Ar SUBDIVISION J?equired!!! Mechanical Contractor's Name: Address P10 0 Kip, Contact Phone: (20b�) ?�f 5 ':s- � M IT) Pennit# Business Name:f r' 1. _Cid �, e �'��,1 State_Aja___dip � •� �' f Business Phone,, (?4o6)__7L .�:. email Fax Mechanical Estimate $ 0 0 (Comm erciaUMuftl Family Only) FIXTURES & APPLIANCES COUNT (Single Family D Furnace Furnace/Air Conditioner Combo —S— Heat Pump 0 Air Condiboner =O:i_ Evaporative cooler - _--�- knit Header Space Heater, Decorative gas-fired appliance Incinerator System -�- Boiler Pool Heater Similar fixtures or Appliances iverrxng Only) Exhaust or dent Ducts % Dryer Vents 4��Range Hood Vents -&— Cook Store Vents -3 Bath Fan Vents ,,Gt-Cher simiIax vents & ducts: 7m Fuel has Wipe Outlets including stubbed in or future outlets Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply) has 0-11 Goal Fireplace Electric Mechanical Sizing Calculations must be submitted with Plans & Application _101 Point of Delivery must be shown on plans. i,.4 Caw o& VC -Bog. 2 Signature of Licensed Contractor License number Date The City i} " permitfee schedide is the saine as i- zdl-ed by the State of1daho Excavation & Earthwork-. Concrete: Masonry: Roofing: SUBCONTRACTOR LIST rler- �.-ne. rK 14.5,0M e - Insulafion: . Drywall. Paintincy: t Floor Coverings: Plumbing: Heating: Electrical: Te._, P1 5 0 Y-) W �= A �)-a v I C' e.. " j bo W Roof Trusses: Floor/Ceiling Joists: Siding/Exterior Trim: Other: A b P 0 i�. vo" -�I' special Construction (Manufacturer or Supplier)