HomeMy WebLinkAboutALL DOCS - 12-00294 - 502 S 5th W - Gas Line & FurnaceFrom:
Sent:
To:
Subject:
su pport@civicplus. com
Tuesday, June 19, 2012 11:24 AM
Natalie Schneider; Amanda Saurey
Online Form Submittal: Mechanical permit Application
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Mechanical Permit Application
Owner's Name
Property Address
Subdivision
Block
Mechanical Contractor's Namex
Business Name
Addressx
155 W. main#9
ZiP"
83440
Cell Phone#*
208-3t7-4t70
Email
rexburg@clayshouseoffire. com
C OMMERCIAL/INDUS TRIAL
Total cost of plumbing system (Contracted Amount)
Total Cost
RESIDENTIAL
New: Single Family Dwelling, including all buildings with
(*Based on living space)
( ) Up to 1_comma_500 sq ft.- $130 ( )( ) 1_comma_501 to 2_comma_500 sq ft.- $195 ( )
( ) 2_comma_501 to 3_comma_500 sq ft.- $260
New: Multi-Family Dwelling (Contractors Only)
( ) Duplex Apartment $260 ( )( ) Three or more multi-family units: $130 per
building plus $65 per unit: ($130 x # of
buildings)+($65 x # of units)
MISCELLANEOUS
Fees
t I Plan Check: $65 per hour
,11 7S/ - S 3OS
rhrnt . -
Carolyn Smith
502 S. 5th West Permit#
Phase Lot
Kevin Clay
Clay's House of Fire
City *
Rexburg
Business Phone#*
208-359-2333
State x
ID
Fax
208-359-
ZJSJ
Includes the cost ofmaterials installed regardless ofthe party supplying it. The fees listed under this inspection shall apply to any and allmechanical installations not specifically mentioned elsewhere on this form.
TN/A VI
wiring being constructed on each property.
3_comma_501 to 4_comma_500 sq ft.- $325
Over 4_comma_500 sq ft- $325 plus $65 for each
additional l_comma_0OO sq ft. or portion thereof
ExistingResidence_comma Modular comma
Manufactured or Mobile Homes co--u and
Detached Shop: $65 plus $tO pei**HVRt
equipment being installed up to the maximum of
the corresponding sq. ft. of the building ($6S+1919
x # of fixtures))
t I Water Heater Replacement: $65
t I Technical Service: SOS p.r?*
[X] Gas Line: $65
o
t I Requested Indflection: $65
[X] Fireplace/Solid Fuel Burning Appliance: $65 per
inspection*Living Space- space within a dwelling unit intended for human habitation with may reasonable be utilized for
sleeping, eating, cooking bathing, washing, recreation, and sanitation purposes. An unfinished basement is
considered part of the living space.
**Examples of HVAC Equipment- fumace replacement, solar, water heater, etc.
Kevin Clay
Signature of Licensed Contractorx
06119/2012
Date x
x indicates required fields.
I 184-1 185
License #x
02t28t20t5
Exp. date x
The following form was submitted via your website: Mechanical Permit Application
Owner's Name: Carolyn Smith
Property Address: 502 S. 5th West
Permit#:
Subdivision:
Phase:
Lot:
Block:
Mechanical Contractor's Name: Kevin Clay
Business Name : Clay's House of Fire
Address: 155 W. main#9
City: Rexburg
State: ID
Zip:83440
Cell Phone#: 208-317 -4170
Business Phone#: 208-3 59 -2333
Fax: 208-3 59-2333
Email : rexburg@clayshouseoffire.com
C
4dt9-e
,-pi$k'
u"*f'.$d, L
Total cost of plumbing system (Contracted Amount): $
Includes the cost of materials installed regardless of the party supplying it. The fees listed under this inspectionshall apply to any and all mechanical installations not specifically mentioned elsewhere on this form. :
Total Cost : N/A
New: Single Family Dwelling, including all buildings with wiring being constructed on each property.(*Based on living space) :
New: Multi-Family Dwelling (Contractors Only) :
Fees: Gas Line: $65,Fireplace/Solid Fuel Burning Appliance: $65 per inspection
*T 'iving Space- space within a dwelling unit intended for human habitation with may reasonable be utilized forsleeping, eating, cooking bathing, washing, recreation, and sanitation purposes. An unfinished basement isconsidered part of the living space. :
**Examples of HVAC Equipment- fumace replacement, solar, water heater, etc. :
Signature of Licensed Contractor: Kevin Clav
License #: 1184-1185
Exp. date :0212812015
Date: 0611912012
Additional lnformation:
Form submitted on: 6/191201211.23.42 AM
Submitted from lP Address: 75.174.43.224
Referre r Page : http ://www. rexbu rq. orq/i ndex. aspx? N I D=4 1 g
Form Add ress : http ://www. rexb u rq. orq/Forms. aspx? F iD= g0
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Billing Information
Kevin Clay
,83440
ffi
Transaction taken by: amanda
City of Rexburg
35 Northlst East
Rexburg, lD 83440
208-359-3020
40 Col, Printer J t
I Transaction detail for payment to City of Rexburg.Date= 0612212012 - 12:41259 PM
Transaction Number: 15836532PT
Visa - XXXX-XXXX-XXXX-6720
Status: Successful
Description lReference # lAmt per ltem F ltems fotal Amt
MECHANICAL pERMtr 11200294 | SZS.OO 1 575.oo
https : //www. xpressbillpay. com/common/paymentjrocess.php 612212012
Transaction Detail for Payment to:
City of Rexburg
Date/Time: 0612012012 - 4:53:02 pM
Transaction #: 158075S2F
Payment Method: Visa
Transaction Status: Failed
Items
MECHANICAL PERMIT 1200294 O.OO
Total: 0.00
Signature:
Payment Service Provided By
wtwil.x p ress b i I I pa y.c o m
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