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HomeMy WebLinkAboutALL DOCS - 14-00034 - BYUI Hazardous Materials Bldg - RemodelBuil Sofety DePorlm 35 N. 1't E., Rexburg, Id 83440 Phone - lnqZS't-ZOZO / Hotline - Q08)372-2344 /Fax- Q08)359-3022 |$E"Y#tXs permit# lrl -ttot,y SUBDTVISION - PHASE -- LOT BLOCK--- City of Rexburg crl'Y oF REXBJ8_G_ Ame ri u\ Fa mily Commun itY Requiredll! ELECTRICAL Electricat contractor's Name L /l ,'o/ S ousiness N{r'" /'^ "&t}r Ed-y't''' ^o*r"" /, o , ,t 4 ?) -'q //a./ dld.A st^t --E/-zip f B'/ 36 Cell phone 12ag7 3 {A *6 3 { hrsiness Phone (Hfi ( ft -? S> S Fax1psglft/,-7365 s^.'t fa,orz''ey'r @ 6t/q'r'/'Q'-n, (COMMERCIAL/INDUSTRIAL) Total cost of electrical system (ConttactedAm ountl$ 374!QE (Inctadtt the co$ of mateiah installed regardless of the parE suppling it. The ret itted u;der this inspection Epe shatl app! to an1 and all electrical installations not sbecifically mentioned ekewhere on thtfonn)'' { Up to $10,000 (total cost of system x 0'02) + 60 = $ tr Between $10,001 - $100,000 ( (Lotal cost of system - 10.000) x 0.01) + $260 = $ ! Over $100,001 ( (total cost of system - 100.000) x 0'005) + $1,160 = $ Small Works (contractors oNL!: $tb'fee for work not exceeding $200 in cost and not involving a change in service connections. Does NOT requite inspection' RESIDENTIAL New: single Family Dwelling, including aII buildings with witing being consttucted on each ptoperty. (*Based on liuing sPace' see definition below) tr Up to 1,500 sq ft - $130 ! 2,501 to 3,500 sq ft - $260 tr Over 4,500 sq ft $325 plus $65 fot each additional 1.000 sq. ft. or Portion thereo0). New: Multi-Family Dwelling (Con ttactots Ottly) c Duplex APartment $260 tr Thtee or -or" -rrlti-fr-ily units: g130 per building plus $65 per unit: ($1-30x # of buildings) + ($65 x # of units) ! Existing Residence, Moiular, Manufactured of Mobile Homes, and Detached Shop: $65 fee plus $10 per branch circuit, up to ihe maximum of the corresponding sq. ft. of the building ($65 + ($10 x # brar-rch circuits)) r Central fferiing/Cooling Systems: g65 when NoT pari of new residential or FrVAC permit vrith no additional Witi.g tr SpasfHot Tubs, and Swimming Pools: $65 fee for each trip to inspect Pumps-Watet, htigation, Sewage (each motor) ! $65 up io 25HP n$95 - 26 to 200HP n$130 over 200 HP MISCELLANEOUS ! Temporary Construction Services ONLY: 200 arrrp or less, one location (fot a period not to exceed 1 year) - $65 n Temporary Arnusemenc $65 fee plus $10 pet ride, concession of genefatof tr Irrigation Machine: $65 for center pivot plus $10 per towet of drive motor tr Technical Serice: $65 Per hour ! Plan Check $65 Per hour il Requested InsPection: $65 *Li..irg Space - space within a dwelling unit intended for human habitation which may reasonably be utilized for sleeping, eating, cooking, bathing, washing, recreadon, and sani An unfinished basement is considered part of the living space' €-77^6 License number & exP. date tr 1,501 to 2,500 sq ft - $195 tr 3,501 to 4,500 sq ft - $325 1,000 sq ft. ot portion thereof ($325 + ($65 x # of additional 8 /*o, 02-25-2014 04:55PM FR0}rl|-LE${l SCORPo 208-237-l 343 T-r rI P 00l/006 F-289 of REXBT]RG " --t1v"- 'l nrr'n,zi lit,tilv (ir[l,rrrrtirl' DryerVents Range Flood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: Pool Heater Fuel Gas Pipe Outlds including shrbbed in or future outlets Heat (Circle all $at apply) Gas Oil Coal Fireplace Electric Hydronic HVC€+q+O Liccns€d Contractor Liceme numbcr Building SofetY DePorlmenl Clly of Rerburg 35N I'E Rerburg, D834{0 vvvrrexlrnlcl,olg Phone:208,372.2326 Fox:208,359.3022 NAME Hazardous PROPERTY ADDRESS Permit# SUBDIVISION Required! ! !MECHANICAL Mechanicat Contractor's Name: Lewis corporation Business Name: Lewis corporatlon addrsss-15136 W Hunaker Tg. iry Po*t"llo starc_ld\zip Ccll Phone: 12081 604'0094 Business Phonc (zoa) 238"1202 Fax ( zoa) 237.1343 Email kenYa!@!con.c9! Mechauical Estimate $ 7,160'00 (CommerciaUlUutti Family Only) FIXTEIRES A, APPLIANaES couNT (single Family Dwelling only) Fumace Exhaust or Vent DucE Furnace/Air Conditioncr Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space Heater Decorative gas-fi red aPPliance lncinerator System Boiler schedale is the same as rrquitrd fig Sofety DePorfm:il C]TY OF REXBURG Ame i cai fsmilY Cofr munilY35 N. 1't E., Rexburg Id 83440 O\X/NER'S NAME PROPERTY ADDRESS Water Meter QuantitY: ll rirvl Eititicttivl Permit# '') **x<*******&F**\V41g1 Meter SiZe: PlumbingRequircd!!! Addtess Cell Phone na"$fp see definition below) ! Up to 1,500 sq ft - $130 n 2,501 to 3,500 sq ft - $260 tr Over 4,500 sq ft $325 Plus $65 (coMMERcIAL/INDUSTRIAL)rotal"9"t9f Pl""-lilg"y:f-t::::.7::"iy2i::lo.n0 (C0MME;l(UlAL/rNL,UJIfi.rA|-,l0faIcust(,fPlftrrrulrr5oyolLlu (Inc/udesthecostofmateiakin$alled.ngardterofthepar4sipp'ingit.il,7utisteiund'erthisinsputionfpethattapp!toan1andallp not Aeciliulh mentioned elsewhere on thisfom)'-Up ,o $10,000 (total cost of system x 0'02) + 60 = $ tr Between $10'001- s100,000 ( (Iotal cost of system _ 10.000) x 0.01) + $260 = $ tr Over $100,001 ( (total cost of system - 100'000) x 0'005) + $1'160 = $ RESIDENTIAL New: single Family Dwelling, including all buitdings with wiring being constucted on each propetty. (*Based on liuing sPace, 1-000 sq. ft. or Portion thereo0). New: Multi-Famity Dwelling (Contractots OnI. tr Duplex Apartment $260 tr Three or more multi-family units: $130 pet building plus $65 pet unit: Existing Residence, and Detached SLop: $65 fJe plus $10 per {ixture up to the maximum of the corresponding sq. ft. of the building ($65 + ($10 x # of fixtures)) ! Gray Watet Systems: $1i10 n Lawn Sprinklers/Backflow Device: $65 tr Modular, Manufactuted or Mobile Homes: $65 for sewet and urater stub connections tr Multipurpose Fire Sprinkler and Domestic Water Supply System: $65 fee or $4 per sprinkler head, whichever is greatet Sewet & Watet tr $38 Sewer Line n$38 Water Line l$65 Sewer & Water- if inspected at the same time tr $65 Sewer turnaround under house (change from septic to ciry) MISCELLANEOUS tr Plan Check $65 Per hour tr Technical Service: $65 Per hout tr Gas Line: $65 tr Vater Heater RePlacement $65 tr Requested InsPection: $65 tr Hydtonic Heating: $65 + ($10 x # of manifolds/zones) *Lirrirrg Space - space within a dwelling unit intended for human habitation which may reasonably be u"lized for sleeping, eating, cooking' bathing, washing, recreation, and sanitation pu{poses. An unfinished basement is considered part of the living space' C tYvr tr 1,501 to 2,500 sq ft - $195 n 3,501 to 4,500 sq ft - $325 000 sq ft. or pottion thereof ($3ZS + ($65 x # of additional License number &Contractor REXBURP fifrt i{rttl'nrai li:rrrih' ( ir+rrntl'uil,1' COMMERCIAL & MULTE FA]VIILY SUILDINO PENMIT AI}FLTCATTON 35 N 1" n, fi.1-IXBURG,ID 83440 2fi8-37t-2326 Please the fintire Applicatio*! If tf* qucmtinn drx* nr:t *p;rly fill in NA firr aom ryplicebb pAItcF:L NL'MBb,& ( we will provide this for you) SLTBDTVTSTON, 4/u -t L4qfr t4.rfflt UNI'['#--B|.OCK# Lo',r# {r\ddressins is based on'the informatio* - mu$t be accurate) OWN#fr NAMfi: . CONTACT PHONhI # pRoPHR'rY ADDRF.SS: / q, " al. "'{4" s " (Tru.//6',€-/l-2A PHONE #: Home APl O$fN IiR MA ILING ;\DDRH'$S:1'2{5" Cet,*ra rJ&8/Be slrvt"E: /f zr?F1co-54 fi,M hIL lal at<on "Kd"B loE cNt F t\X w*rk tp+8 46-e(zgt t:rlt{p6@ ht,rag bIvL ,e4 a APPI!.{CANF flf ather than ownc (;\pplic*nt if other than orrrncr, a statement authr:rizing epplicant fo act as ag*nt fnr o\*Trer must iccomptny this appllcation.) AFFLICAN"I' INFORhIA'I'I0}*]: i\DDRESS CI Y: S'l:\'I'[i:ztp_ EhfAIL -.. ttAX PFIONI: #; Flome ( ]Wotk( )Cell ( ) CONTKACTOfrI MAIT-ING ADDRESS: l'FIONI'l: Cell# CITY.. TE ZIF Wotk#Fax# h,h,{AII, II}AHS HSGI$?RATION # & E}frP. T}dTE llow many buildings are located on this ptoFerty? -;"\ [)id yau rece*tly F{phase this ptope*ty@,rt"t (}f yes,list previ*us ownef'$ name) Is this a tot split$id YF:S please bring copy *f nc'w }cgal tle*cription of prope*1of prope*y) FROFOSH$ USE: fonh&)r'M. * ttr,ryfu S /'r,tl,{f// (i.e., Single Family Resiclence, r\lulti Family, r\pnrtrncnts, Remodel, Gat'rge, Commcrcitl, Idclitio*, Htc) - CIRCLE ONE APPLICANT'S $IGNA'IURH, CIIRT;flICATION AND AUTHORIZA'IION: Urrrlupcnalty r:{p*riur1, I he*by ccrtify thnt I hrvcrerdt!i*,,rpp|icationand*t*rethttth*infi:rmntiorrlrrr*iniscnrl*ctrrdlsrr'earthatrrryi*f+rmtti<x,:uuhic ll*nning rnd Ztning (ictmmis*i*r or th* (iity C t*thrsubjectmatteiof*hisnpp1icaticlrr*ndhercby:rat}r+rixttir*prcscntativ r,pplicnti<rno,9nihepl*.so7rvhichthcprrrrritotapprova|rvn*b***rJ,Fsrmitvoidifrrtltlitl*tdwithinl8{)davs.Pcmitvrlidifrvtrrksttsfol| -/ / ;'-) // tP? / P/4 DATl- to b€ cont*cted by fax, crnnil $t ph#nf,? C*rck Onc \fARNtFfff *AtItLDtNc rBRMt? MU$T AE fOSfED olil CON$TRUCTI*N $lTS! Ffun frte *m non-nfurieblc snd m peid in futl et thc timt of *Fpli{*lioil btginning ftrusryi 4ff5. Ciry cf Rcrhurgh Acctp*unrr of tl*r pl*r mviw f* d$ile not coi*tiruta plrn egpreval *Building Pcmit Fcc* rm drc na timc of epplicrti*n# {*Suilding fcffiit* rfr Yoid if ysur chcck docr ao: clc*{* Dct you Done NA {r AP N/A TI AP REVtr 14 00034 BYUI Hazardous Materials Bldg - Remodel Routing: Building Quinton Owens (Please review by Friday, February 7) F ootinglF oundation Permit Current Status Please complete the following: Done NA tr I Review Plans f n Enter Notes for the applicant under Checklist in the Workflow .W I UPdate result in the Workflow V I Stamp office copy and jobsite copy W I Return building plan and this check list to Amanda Saurey Please indicate time spent in hrs/min reviewing the plans 1 /f, '^',"' Notes: ?t.6Ls& saPPly .-'f#' ?n^ oi ilra*e{iaJs (h/r'"@75 tE bJ' st-r-'l 0U30l14 in bu' ld''n t'* ffi ]s'lc: 14 00034 BYUI Hazstdous Materials Bldg - Remodel 0112912014 Routing: Electrical oot' M Bret (please review by Thursday, February 6) Current Status Please comPlete the following: NA n Review Plans I Enter Notes for the applicant under Checklist in the Workflow I Update result in the Workflow I StamP Jobsite CoPY I Return building plans and this checklist to Amanda Saurey please indicate time spent in hrs/min reviewing the plans : .\ |Notes: N/4. NA I nnl M AP T oo"y' V "/ V T V 14 00034 BYUI Hazardous Materials Bldg - Remodel rl29l14 Routing: Plumbing Done, lz H Don Allen (please review by Thursday' February 6) Ap ,/ REV / n Current Status Please comPlete the following: Dony' NA il [ Review Plans a/ n Enter Notes for the appricant under checklist in the workflow ,7 { tr UPdate result in the Workflow {' a Return site plan to Amanda Saurey tr please indicate time spent in hrs/min reviewing the plans: lt H tL Notes: 14-00034 BYU-I Hazardous Materials Bldg- Remodel 0212012014 Routing: Electrical Revisions oot{ NA dr x/ REV vrl Bret (please review by Friday, February 21) Current Status Please complete the following: NA n Review Plans n Enter Notes for the applicant under checklist in the workflow ! Update result in the Workflow I Stamp Jobsite CoPY x Return building plans and this checklist to Amanda Saurey Please indicate time spent in hrs/min reviewing the plans ' 'l-*' Notes: \Ut Oorr/il M t4 d t 02-25-2014 04r56PM FRO[|''LEWIS C0RP 208-?37-l 343 T-r lg P.002/005 F-289 f--t**,;* - I oxt'I(r'rvxI fl\tluaru^lt[_i:TT agEji-t' Q/vl F.oz H Hi ,y'rr, :\N erE iEe€6l \lu)& 5? =ila8 JIalt:I619 slr?ti-d) =iHI>l ulol6l OI:gii 5liLir,') 3lHolo Rli uri=t; Llo >l-lr-19 =tl5l*fJl @ I$t EtI"Eu 86 ilIt ! E Ie7 t'vBii 02-25'?014 04:56PM FR0}i{-LEWIS CORP 208-237-l 343 re' Fan'C-Lea 5-55 MOdEI: VDBAOTL1 Air Performance 70DegF@0ft 500 0.250 sP 0.05 771 Motor Details H.P. 1t4 TYPE HiEff rE (VFD) ELEC 115v/1Ph Sound Data (dB re 10'r2 watts) INT BELT DRIVEN DUCT BLOWERS T-r l9 P.003/006 F-289 QtY:1 Dimansion.s Fan OPtions Selected I Disconnect Switcii Mounted -- --l Accessories Selected b;i$ngSprins-tsotaior' -"1 See next Page for vFD Octave Band l'tlzlsl+l5l6l7lE I og lzt I s7 l40 L40 i 351 3_s_EI 1000/. sE BO 4o P R Eg0 S U R E 0 -sPrFtow - P9q1s3 - SYstem G StEilc ett. An economlcarailaeffcient all purPo=e _l inlino duct blower for indoor use with i Standard Features Attractive green baked enamel paini Molor recoives the cooling benefits being in the air stream for increasect Shaft flats are standard on bolh ends for C1A/ or C$A{.r919!i9{t,. Hook bolt motor aojustmenl-itt6G models VOBA 07 to 12 and 27 to 32 units to be used in uP.ffow, down'flow and horizontal discharge PosiUons. f-f eavy Outy motor mounting bracket with motor adjusting bolt and rubber bumper is supplied on models VDBA 15' 18 and 02-25-2014 04:57P[| FRO['|-LEWIS C0RP 208-237-l 343 ,I ADBDfEtEpE@ T-t lg P.004/006 F-289 Votboo: llo VAC I outirr cwEntr.4 AMPS D4vo only Horiopowor 0-25 6lz9: A Nono ltnpcdrmc: c17. cicutt Cwmt RldnEr 65 KAIC Protocolgl Nma I \mn (600 Vl hrGm!ni TYs 0 J916 !.tErmcc DEwlnoS Wdnq .^^.tbn Olr()Incn5lon Detrll ,,lrA I'A rc590_A ttPE coDE: ACSsil1E{lA+1 "[O0uCl COtaPIETA lrl9ut VoltoSo; 12O VAC ltlrur Photo: Singrla Phwo HP O'?5 Etrilc Filtot: Inlogr0leo Ett4c Frllor Roteo O\la[r\r A.nPt; l'4 oulput volt.rt€: 200?40 v Frsno 5it6: a Klu & 8o@n Lllt Ptlce: 2ll4l20r4 [ "-,ti:"'* T-llg P.005/006 F-289208-237-l 343 tr\ll(rll'lg oNrrc wH STVTA?M.I snoc[v-z\rH 02-25-?014 04:57PM FR0}'|'IE$I|S C0RP sisE n<3HE EgE ,igEi*Eiffi*'H liffiffi$llfil ll I : : c{ 3sF i elB t, ' ! Fx F ; rl FEo t-._gfi e2ERgE Lre c IIt Eq ils ct)rrl57z (J -1-- --: q- jl :! ,. cbbE E;ax Ei e-t =l@ lcsr t Tu? _&-t'l--I I q! f r EiEiiiEEiE,!E 3E IEEi*H: ;lsEiisHEEH L:9; , V I F DE{i ;tr?2E; iililtf ::,:,::ii h.,,.- -.ty! i:1jl : -to L)e u')3(\) 43L&g g?-25-2014 05:00PM FR0M-LE|V|S CORP ?08-23i-l 343 'NI(rIIOg ONTTCWVT{ tTvru?-Lwa Snoqtw-zvll T-120 P.005/006 F-289 Fffitiil=3mL - d;4 . I ct)145zza(J sf;gIgr EiE EBHEEE EEt I ;Ef,p 3rBg(b ?x tt ? ?"i:lt 3vE E $rln C t9;' FnEirB 63: eli,is aF I I7 5f x3 saaaErgT :8ril EfX t E I E f?s d Fr D,E i;e 6 $t)t rIEg ag E ItIB:-<ts rft:igiili {:: {YIi!ifi ::l l.'.'J 1,, d iiifT;,E '-n{ A::r-J ili Es?Fi Hi;E5-I t 8e l,/x,r i B1,, Et_;-jj E;a.J: c,i,l I sr E , F --ll ! I t -l I : \ n 1 B t EE6t :iii,-4 t;;xr .eE6 -i l- '--.---n - r+ I l1; --"-+ffiq : t-6de+I- 'r ft e -Hi Ei En I ll bF rF+'| t Itl., n r,H@ E_ It .fsrB?6 tl -o()e F(na(J= tr tR:i cg6 31" AE H|i.-' ?1.' g 02-25'2014 05r0lPM FRO|I,|-LEWIS C0RP T-r 20 P.006/006 F-289208-237-l 943 @ App[ed Applied Comfort" WallMate Built-in Air Conditioners. Complete comfort with easy to use controls' Direct fit replacement for many models' so allyou have io do is taki out the old unit and slip in the A pplied comiort Buitt-ln Air condilioner. lt installs in most major Jfteves without additional cost of adapter kits or wall remodelling. High energy efficiency with mod.els up.to 9.5 EER saving yo-u energy costs compared to the units you are replacing. Installs weatherti ght in use of optionaltrim kit- Electrohome / APPlied Comfort / Keeprite / RCA / Admiral/ Beaumark-- 23 15 9132 F{ruestinohouse 24 ln 14 1t2 -aiAEa ?4 5/1b 4 GE 2s 1t4 14 518' Frioidaire 25 7t8 15 7t16 EriedriEhlJSc--25 7t8 1517132 26" GE / Amana / Sanvo ST 26 15 5/E Friedrich 26' 5/8 :' 16-1.1/15 , Whirlpool / Friedrich \ /SC / Fedders 26 314 ri v+ Easy to access, easy to remove, easy to.clean poly'propylene filter: no tools required' 1007o FULL factory;run tests'are p-erfo-imda' on Bll unitd lo- g-r!-s..u-ig,high reliability.and.dependability' "@;" '+Way ao itistaol e ai rfl ow to oi reci:,iodi 9opf9 rt !o-: ?_n Y".-.a t-e-?..of a r oom. 3-cooling speeds and 3 fan-only speeds to enhance Installs weathertight in most cornmon sleeves with the 115v -'l5A 14 112'(36-8 crn) 22114" lffi.'cffi) comfort. ktir,rlSdEfyAdlottv Giiffi ,' s " b. t *: ? ?-?!g 2 Y:: l: 2Y1g,,.rE'w't'ctsv'l- r -'''Siiiii'tEaian*enur.eotneit,'sl*lvootrE Arl D@trds 6Dct FttJuCl ONfr€6 anvdg - Electrical Permit https ://www.xpressbillpay.com/utils/printerFriendly.phpa Print - Close Xpress Bill Pay - Transaction Details Transaction Details XBP Confirmation Number: 167096 IrTransaction detail for payment to City of Rexburg'Date:0212012014 - 12:49:36 PM Transaction Number: 248991 06PT Visa XilX-XXXX-XXXX-3484 Status:Successful Account #:ltem iQuantitY ;ltem Amount I Extended Amount , st 35.2Al$135.2014-00034 TOTAL: 51 35.2A Transaction taken by: amandaBilling Information LON RICKS .83440 21201201412:49 PIt (pt.tt Bill Pay - Transaction Details Billing Information Christy Fyfe , 83440 htps : //www.xpressbillpay. conr/utils/printerFriendly'php Print - Close Transaction Details XBP Confirmation Number: 210659 payment to CitY of Rexburg. Transaction Number: 24971 630PT lllhstercard XXXX-XXXX-XXXX'2328 Status:Successfu{ Date; 021 241 201 4 - 12120t25 Quantity 1 It€m Amount $163.00 Extended Amount s t 63.00 TOTAL: 5 t63.00 Transaction taken bY: amanda 212412014 12:20 PM Kpress Bill Pay - Transaction Details htps://www.xpress v TOTAL: 5268.20 Transaction taken bY: amanda bi llpay. conr/uti I s/printerFriendly.php Print - Close Transaction Details XBP Confirmation Number: 258308 Billing lnformation LeWs CorPoration Lewis Corporation ,83202 [i;;;;;;ffi;;*it9lffi Datezo2t26t2o14'4:$:31 I*--*- - Transaction Number: 25040025PT I Visa )fiXX-)fiXX-XXXX'2421t-i status:Successfult ,,_-*M l;;ffi# .* h;;-^ - o,i""iitv ,ltemAmount ExtendedAmount 212612014 4:45 PM i::'iY iir ill:iiiL:iil ii].li: 3Ti i'iX-i l}il i-: 'it; i:'qji t itii:: l'r;li-lu'i ;ii lii:iLi:.iiiii i'ij-!;li:i H'ij'iiJ:.:i.1,jli'iJi. ii!"tf :i''i ilil; .iiii-i-l iii:i: l;ii: ?;;iii ,'iF_i'J,c 'l'riii , iil rG nunity Date: 0112812014 ReceiPt #: 735 i;'fit tl. iiiilii!t'i i i'* iiitiiT iltt:iiui i'i:illiiT ii{ niii:r;4 'iiirii'ifi Yriii *rill ili'+i" ir i'ili[ Iii+: :iiil ,,ll ':'l[ ,';ii Ll ' 'j'ti BYUI Hazardous Materials Bldg - Remodel 525 South Center Permit #: 14-00034 Permit Type: auo-colvlR Please contact the Building Department at (20g)372-2341 for further questions about this receipt JAN 2 8 IC;3 cfw oF RELBURG 24Hour Notice for insPections Gall insPection hotline at (2081372-2344 .**Credit card payments are accepted, but are subject to a 3% convenience fee on payment amounts over $500*** City of Rexburg Receipt#:1104 Date:2/28/2014 t--BLD-COMR 14-00034 i -- ," I, :^-''''.--''_*--...-.. Sub Total: C-BLDP DEPAPPLY. E-PLANREV- Ele"ttir4 Jl"g&rlgy J99 [iTY ilT F:E]{5UEE F*Iii E:T; IiL Fi[]i' jl''lf. iiAT[; i]l,'it,ri4 iiF ,"il::fi,/[i'iiF: Tii{tr i0:iI:0i' F:tiiIfT l'iil: li'{6*! F:ii l{tlr "q?ii t :J Fr, FiJIL. rEftiiiT$ ui,$t lij ILI|I i'iii F[F:i{ I T irtFr-]i BUILIiii'Iff Fit:iiiT irif il: rF tltiT. i'tt:iiiT ,: : tF, FiIIL IiiP i'Ltllili'iiili nltL5 , +T ii:ii,lll -ioil. [Ll i-q ntl I 1ii ,.iY t.tc,18 u " i_]tj IHtCii 'i]iLtLiijT rH i fiLt{ | LflHIIUL FrftfiiT +ti4iliiilI4 THriiifi iilU *iilr HA'it S i'iiLli liAY fotal Amount Due: Total PaYment: Code: REXBURG-Recptl 104-28 2 2Ol4-frontdesk T,i:Ii BPD 100.00 Page: I ofl ----""* -i- , Sub Total: i Received By: frontdesk