HomeMy WebLinkAboutAPPLICATION - 07-00369 & 370 - 60 W 2nd S - ElectricalBuilding Safety Department Q4�EXBVR�
City of Rexburg
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19 E Main janellh@rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: ?nR.359 -3024
CITY O F
REXBURG
America's Family Community
OWNER'S NAME ' NV IL-�Ca;-ff— 07 0 0369
PROPERTY ADDRESS be, w n
SUBDIVISION 60 VV Ui S Electrical
PHASE LOT BLOCK
Required.!! ELECT CAL
Electrical Contractor' s -� cJ� I S Business Name
Address
/� City State-4-VT Zir C'
Cell Phone (.208) �d — �/(p / Business Phone (2 I�SCo -- 0!�4W�
Fax oq) 6:.S(49 c� (Q Email P k Wit? C0�1
Electrical Estimate (cost of wiring & labor) $ U (COMMERCIAL /MULTI - FAMILY ONLY)
TYPES OF INSTALLATION
(New Residential includes everything contained within the residential structure and attached garage at the same time)
Number of meters being installed
Up to 200 amp Service*
201 to 400 amp Service*
Over 400 amp Service*
Temporary Construction Service, 200 amp or less, one location (for a period not to exceed 1 year)
Ull Existing Residential (# of Branch Circuits)
Spa, Hot Tub, Swimming Pool
Electric Central Systems Heating and / or Cooling (when not part of a new residential construction permit
and no additional wiring)
Modular, Manufactured or Mobile Home
Other Installations: Wiring not specifically covered by any of the above
Cost of Wiring & Labor: $
Pumps (Domestic Water, Irrigation, Sewage)
. Requested Inspections (of existing wiring)
Temporary Amusement /Industry
*Inclu maximum 3 inspections. Additional inspections charged at requested inspection rate of $40 per hour.
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Signafure of Licensed Contractor License number Date
The
schedule is the same as required by the State of Idaho
n * - "Building Permit Fees are dt�- time of application" "Building Permits are V you check does not clear"
Please complete the ere Application!
If the question does not apply fill in NA for non applicable
NAME
PROPERTY ADDRESS
SUBDIVISION
Dwelling Units:
SETBACKS
FRONT
SIDE
SIDE
Remodeling Your Building/Home ( need Estimate) $
Permit# C; CO3 U
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area
Second floor /loft area
Third floor /loft area_
Shed or Barn
Unfinished Basement area_
Finished basement area_
Garage area
Carport/Deck (30" above g
Water Meter Count:
BACK
Water Meter Size:
Required!!!
PLUMBING
Plumbing Contractor's Name: 3 rte Business Name:
Address i v ;" => City (L �- State n Zip "
Contact Phone: (Zc�) '7; (- e i ems\ Business Phone: (
Email g v—a',\ ( c 4-+ . e.a \,, Fax
FIXTURE COUNT (including roughed fixtures)
Clothes Washing Machine
Dishwasher
Floor Drain
Garbage Disposal
Hot Tub /Spa
3 Sinks
(Lavatories, kitchens, bar, mop)
Sprinklers
Tub /Showers
Toilet/Urinal
Water Heater
Water Softener
Plumbing Estimate $ (Commercial Only)
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Required. Signature of Licensed Contractor License number Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
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Parcel Acres: