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Home My WebLink AboutALL DOCS - 17-00009 - 949 N 12th W - Gas Line and Heaters Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM will be scheduled for the next business day. Inspection Hotline – (208) 372.2344 www.rexburg.org Permit Technician – (208) 372.2341 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 BUILDING APPLICATION Miscellaneous Mechanical Work For Office Use Permit Number: ____________________ ⧠ Mechanical Fees Paid 1. Property Owner Name: ___________________________________________________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone: _____________________________________________ Email: _____________________________________________________________ Under Idaho Building Code, a homeowner is allowed to do work on their own home. Are you a homeowner doing work on your own home? ⧠ Yes (Skip to #4 and complete the Homeowner’s Exemption) ⧠ No, I am working with the homeowner 2. Mechanical Contractor Under Idaho Building Code, a registered contractor must do the work for a Commercial Building. Business: ___________________________________________________________ State License #: _________________________ Exp.: _______________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone: _____________________________________________ Email: _____________________________________________________________ Contact/Rep. Name: ______________________________________ Phone: _____________________ Email: __________________________________________ Mechanical Contractor Authorized Signature: ____________________________________________________________________ Date:________________ A copy of your state registration/license is required to be on file. If this is the first time you have done work in the City of Rexburg, please provide a photo copy of your license. If you are unsure if your license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address: _______________________________________ -OR- Lot #: ____ Block #: ____ Subdivision: _______________________________ What type of Property: ⧠ Residential ⧠ Commercial Cost of job: $___________ Description of work: _____________________________________________________________________________________________________________________ 4. Fees: Check all that apply:⧠ Furnace or A/C = $65 ⧠ Gas Line = $65 ⧠ Water Heater = $65 ⧠ Fireplace/Solid Fuel Burning Unit: o Built-in = $130 o Free-standing = $65 ⧠ Miscellaneous/Requested Inspection = $65 Inspection fees can be bundled upon request. Re-inspect fees will be enforced if inspection requests exceed fee totals. APPLICANT’S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I have read this application and state that the information herein is correct and I swear that any information which may hereafter be given by me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct. I agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2012 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Applicant’s Name (print): ___________________________________ Signature: _____________________________________________ Date: _______________ BUILDING PERMIT FORM Updated 10/2016 410 Daniel Marshall 949 N 12th Rexburg ID 83440 208-534-8191 xx Fall River Enterprises, Inc. HVC-C-1171 10/17 1150 N 3400 E Ashton ID 83420 208-652-7431 missi.hathaway@fallriverelectric.com JT Hill 208-652-7431 jt.hill@fallriverelectric.com Jt Hill 1/9/17 949 N 12th xx 4000.00 installation of gas line and 2 gas heaters Melissa Hathaway Melissa Hathaway 1/9/17 Inspection Ticket HVAC Final Inspection on 01/20/2017: PASS Permit Number: 17-00009Permit Details Madison County Mechanical Residential Permit Issued Date: 01/09/2017 Final Inspections Required 949 N 12th W 949 N 12th W - Gas Line and Heaters Inspection Details don.allen@rexburg.org Inspected By: Don Allen HVAC Final Inspection on 01/20/2017: PASS D ESCRIPTIO N CO MMEN TS STATUS Approved for a Final and C.O.Heating 2 units on the main floor and 2nd floor of the barn located at the south west Look good. COMPLETED Inspection Ticket Gas Pressure Test on 01/20/2017: PASS Permit Number: 17-00009Permit Details Madison County Mechanical Residential Permit Issued Date: 01/09/2017 Final Inspections Required 949 N 12th W 949 N 12th W - Gas Line and Heaters Inspection Details don.allen@rexburg.org Inspected By: Don Allen Gas Pressure Test on 01/20/2017: PASS D ESCRIPTIO N CO MMEN TS STATUS Gas pressure held LOW 20 LB for 20 min Held at 20 lb APPROVED Permit Inspection Summary Permit Status of (Open) as of Report Date: 01/26/2017 8:38 am Permit Details Permit Number: 17-00009 949 N 12th W - Gas Line and Heaters 949 N 12th W Madison County Mechanical Residential Permit Issued Date: 01/09/2017 Permit Inspection Statistics 1Total Inspections Completed: 1Total Inspections Passed: Inspection Pass Rate 100.00% Permit Inspection History *Refer to Individual Inspection Report for more Details Mechanical Inspection Type 01/20/2017PassDon AllenHVAC Final Inspection 01/20/2017PassDon AllenGas Pressure Test Transaction detail for payment to City of Rexburg. Date: 01/09/2017 - 10:31:14 AM Billing Information Fall River Enterprises, Inc. Fall River Enterprises, Inc. , 83420 missi.hathaway@fallriverelectric.com City of Rexburg 35 N 1st East | PO Box 280 Rexburg, ID 83440 208-359-3020 ub@rexburg.org XBP Confirmation Number: 25368352 Transaction Number: 62263660PT Visa — XXXX-XXXX-XXXX-5402 Status: Successful Account # Item Quantity Item Amount Mechanical Permit 1 $65.00 Notes: Permit # 17-00009 TOTAL:$65.00 Transaction taken by: coltonm Xpress Bill Pay - Payment Processing https://secure.xpressbillpay.com/common/payment_process.php 1 of 1 1/9/2017 10:31 AM