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su pport@civicplus. com
Thursday, July 12,2012 3:31 pM
Natalie Schneider; Amanda SaureyOnline 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
Delynn sasser
ZiP*
8322r
Cell Phone#*
208-680-0614
Email
delynns.refri geration@ gmail. 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: ($130 x # of
buildings)+($65 x # of units)
MISCELLANEOUS
Fees
t I Plan Check: $65 per hour
t I Technical Service: $65 per hour
view a Text version.
Ron Fisher
375 Annis HWY Rigby 83442 permit#
Phase Lot
Delynn's Refrigeration
803W HWY 39
City "Blackfoot 83221
Business Phone#x
208 684-3649
State x
ID
Fax
Total cost of plumbing system (Contracted Amount) $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 elsewheie on *,i,5r..Totsl Cost
RESIDENTIAL TN/A VI
fyt Single Family Dwelling, including all buildings with wiring being constructed on each property.(tBased 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 l_comma_00O sq ft. or portion thereof
(X) Existing Residence comma Modular comma
Manufactured or Mobile Homes
"o--u and
-
Detached Shop: $65 plus $tO pei**UVRt
equipment being installed up to the maximum of
the corresponding sq. ft.of the building
($65+($10 x # of fixtures))
[ ] Water Heater Replacement: $65
[ ] Requested Inspection: $65
Total cost of plumbing system (Ctu"t"a 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: Gas Line: $65
*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: Delynn R. Sasser
License #: HVC-C-1528
Exp. date :0313112013
Date: 07/1212012
Additional Information:
Form submitted on: 7 11212012 3:31:27 PM
Submitted from lP Address: 63.227.130.109
Referre r Page : http : //www. rexb u rq. o rqli ndex. aspx? N I D=4 1 8
Form Add ress : http ://www. rexbu rq. o rg/Fo rms. aspx? F I D=90
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ACTION REQUIRED:
Signed Inspector
Rec't
CITY OF REXBURG, 12 Center, Rexburg, Idaho 83440
White - Office Copy Yellow - Job Copy Pink - lnspector's Copy
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