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Mechanical Permit Application
Amanda Sau
From:
Sent:
To:
Subject:
Owner's Name
Property Address
Subdivision
Block
Mechanical Contractor's Namex
Business Name
Addressx
PO Box 1692
ZiPx
83403
Cell Phone#*
208-542-4545
Email
di spatch@ sermonserviceandelectri c. com
C OMMERCIAL/INDUS TRIAL
( ) 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 $65 per unit: ($l:O x # of
buildings)+($65 x # of units)
MISCELLANEOUS
Fees
[ ] Plan Check: $65 per hour
su pport@civicplus. com
Thursday, May 10, 2012 3:5g pM
Natalie Schneider; Amanda Saurey
Online Form Submittal: Mechanicdl permit Application
Shane & Melissa Kilpatrick
252W 3rd N, Rigby, ld 93442 permit#
Phase Lot
Ted Sermon
Sermon Service and Electirc
City "
Idaho Falls
Business Phone#x
208-542-4545
State x
ID
Fax
208-s22-
6301
Total cost of plumbing system (Contracted Amount) $Includes lhe 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.Total Cost
RBSIDENTIAL TN/A VI
New: Single Family Dwelling, including all buildings with wiring being constructed on each property.(*Based on living space)
( ) 3_comma_501 to 4_comma_500 sq ft.- $325( ) Over 4_comma_500 sq ft- $325 plus $65 for each
additional 1_comma_000 sq ft. or portion thereof
(X) Existing Residence_comma_ Modular comma
Manufactured or Mobile Homes co-mu and
Detached Shop: $65 plus $tO pei**UVAI
equipment being installed up to the maximum of
the corresponding sq. ft. of the building
($65+($10 x # of fixtures))
[ ] Water Heater Replacement: $65
,onour
*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.
Ted Sermon
Signature of Licensed Contractorx
5/1012012
Date x
x indicates required fields.
hvc-c-1 156
License #*
The following form was submitted via your website: Mechanical Permit Application
Owner's Name: Shane & Melissa Kilpatrick
Property Address: 252W 3rd N, Rigby, 1d83442
Permit#:
Subdivision:
Phase :
Lot :
Block:
Mechanical Contractor's Name: Ted Sermon
Business Name : Sermon Service and Electirc
Address: PO Box 1692
City : Idaho Falls
State: ID
Zip:83403
Cell Phone#: 208-542-4545
Business Phone#: 208-5 42-45 45
Fax: 208-522-6301
[ ] Technical Service: $65 per
[ ] Gas Line: $65
o
[ ] Requested InspEtion: $65
[ ] Fireplace/Solid Fuel Burning Appliance: $65 per
inspection
9/3012013
Exp. date
Total cost of plumbing system (Contracted Amount): $
Includes the cost of materials installed regardless of the party supplying it. The fees listed under this inspection
shall 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) : Existing Residence, Modular, Manufactured or Mobile
Homes, and Detached Shop: $65 plus $10 per **HVAC equipment being installed up to the maximum of the
corresponding sq. ft. of the building ($65+($10 x # of fixtures))
Fees: not checked
*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- furnace replacement, solar, water heater, etc. :
Signature of Licensed Contractor: Ted Sermon
License #: hvc-c-1156
Exp. date :913012013
Date: 5110/2012
Additional Information:
Form submitted on: 5/1012012 3:58:35 PM
Submitted from lP Address: 174.126.27.25
Refe rrer Page : http ://www. rexb u rq. orq/i ndex. aspx? N I D=4 1 8
Form Add ress : http ://www. rexb u rq. o rq/Fo rms. aspx? F I D=90
O rNsPncrroN rrcKnra
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Inspction Requcst: Rec'd By ,-/:4ryf,ndlA Date .5-ll - lA
Req. By Phone No.
prujecr kf (. t["ni? pennir No.I ?- oa>a'l
Address
Inspector's Report F Res D comm.
INSPECTED ITEMS CONFORM TO APPROVED DWCS
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ACTION REQUIRED:
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Rec'l Acknowledged
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