HomeMy WebLinkAboutALL DOCS - 16-00294 - 3623 W 3200 S - Gas Line�
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CJ1'YOP ·� REXBURG w ""'
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BUILDING APPLICATION Mechanical
Bulidlng Safety Department
City of Rexburg
35 North l•t East
Rexburg, Idaho 83440
Permit Number: _____ _ Permit Type: 0 New O Remodel O Addition O Basement Finish Fees Paid: CJ Yes '](No
Name: R" � I.A_ 1/c,, 01"§. , l.Proprrty Olr�I
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State: .:IJ:l. Zip Code: ___ _AddresJ� J9'i240 Sovfh. Clty:'.].c:.xburg Phone & Type: Cl Office O Mobile 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? CJ Yes (Skip to #3 and complete the Homeowner's Exemption page) l;i[No: I am a contractor working for the homeowner Cl No: This property Is a Multi-family Residence or Commercial Property.
NOT!�; Any i.:'011trai:tors/s11l�(;Olll·rnctor,; Involved wm r,Qqd II) s11bmlt thiJlrowr, slgtrnd app�t·iJtkms.
Name:+ (£P�log;i. ea 'Y),Oi Inc . Registration#: ( .. 12.:J 2.Mechanical Contra�or ! Exp.: 9 } 20 I.QiZip Code: &3 4-0 "!> ,Addres� iho S ctG'l; Cl�do be, '1' O e Ls. State: ::J.:l2 Phone & Type: 20t:l-�-l;!ko5 CJ Office 15a'Mob!le llmall: ______________ _ Contnc:t/Rep. Name;{:.to.u.(ti MG\t l I na2.Phone: .2DS,,::,:W-�S Small: __________ _
Mcchonic:al Contractor Authorized Signature, C e $OX Qooh.era.s.• Date: Y.-\ )• ltt .
3. Project Description Address: 3G. U I.A.' , ;,ZCO SoL?th , -OR·Lot#:_ Block#:_ Subdivision:---------Check one: ci1'ingle•family Residence O Multi-family Residence Cl Commercial Check one: CJ New Construc1:lon• CJ Remodel CJ Addition CJ Basement Finish Description of work: N,,w Commer�lnl Work: Contracu,d amount:·---------Calculated Fee (See Below): ·-----0 $10,001-$100,000" ((tot.al cost of system •10,000) x .01) + $260 CJ Up to $10,000 = (tot.al cost of system x .02) + $60 CJ Over $100,001 = ((toml cost of system -100,000) x .005) + $1,160 New Single-Family Residential Wo1-l<: Sq. Ft. CJ Up to 1,500 Sq. Ft= $130 CJ 1,501-2,500 Sq. Ft= $195 CJ 2,501-3,500 Sq. Pt.= $260 CJ 3,501-4,500 Sq. Ft= $325 0 Over 4,500 Sq. Ft" $325+(65 x #of additional 1,000 Sq. Ft (or portion thereof))$, New Multi-FamilyResldential:DDuplexc;: $260 0 Three or more units" $((130x#ofbu!ldlngs)+(65 x #ofunlts)J$ New work 011 any other i'e,idcnce and Detached ShOJl.8: = $(65 + (10 x # of HVAC fixtures)]$ . Mlsccllanuou;: CJ Gas Pressure= $65 Cl Furnac::eorA/C = $65 CJ Water Heater= $65 CJ Request.ed Inspection= $65 )i'Gas Line= $65 0 Fireplace/Solid Fuel Burning Unit= $65 0 Technical Service= $65/hour CJ Plan Check :::10% of Contracted Amount
AJ1Pl,ICANTS SJONATURJ::, CltR't'll�ICATION ANI) AUTHOIUZATION; Und�r peni�lty of perjury. I lu�rcby �rtlfy that I havo read th!$ appllmtlon and :.tn� that t� ln(ormal;lori here hi l.s corrocland I swear thu.tuny infomuitlQJ} which moy luireaftcr bq alwn by me In hoarlng1> before tho Planning ond Zoning Commwion or tho City Council (or tho City of Rexburg shaD be truthlul and correct. 1 "'s.ree Lt! comply with :11l City regulolion,..: ond St.ate laws relating to tm subJeGt matter of this appUes:tion end hereby authorl:zcd rcprcs�ntnUvc;'i or the
City to enter up1,t1 Uw nhOw"mcntioncd propcrt;y ror inspections purposes. NOTE: The building official moy r�voki: ii pcnntton upptoVhl l:l:stied under \he proviskim orth� 2.012
lnltfnu.tlona.J Code in case:,; 9f•ny la�e :ttutc!mont or mlsraprasi,nt.aUon of fact In tm 1:1:ppllaiUon or on tho pta.n.s on which the parmJtor opprovul was bmed. Permit void Ir nut ·-···"·"· •... ··"�··· . .,...
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Applicant's Name (print): +te:c<loroJ\e.o��...:Ii.:it:...Slgnature: . � ·--Date: _g_ IL� J� .
lns:�ctkuu: must. be t:jt,Jlt!d In bt'rore 8 AM on the dny the lmpt!'ctlon 15 �qut'Sted lnspoo�fon rl!qu,:ists tJll!Ur.d i� Atlr,r 9 AM �U l;t,) sr.h•nfolOO (or the nr,xt b11s:ioos:s dny. fn,pcction Hotlioo .. (:i!Ol:IJ 372..2344 www.rexburg.org Pcrmlt'rcduD�iiln .. (208) 372,2341 Revised March. 2016
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Permit
Inspection
Summary
Permit Status of (Open) as of Report Date: 02/06/2017 5:11 pm
Permit Details Permit Number: 16-00294
3623 W 3200 S - Gas Line
3623 W 3200 S
Mechanical Residential Only
Permit Issued Date: 04/13/2016
Permit Inspection Statistics
Total Inspections Completed:
Total Inspections Passed:
Inspection Pass Rate
Permit Inspection History *Refer to Individual Inspection Report for more Details
Mechanical Inspection Type
04/14/2016PassDon AllenGas Pressure Test
Transaction detail for payment to City of Rexburg. Date: 04/13/2016 - 4:41:39 PM
Billing Information
Freedom Heating Freedom
Heating
Idaho Falls, ID 83405
City of Rexburg
35 N 1st East | PO Box 280
Rexburg, ID 83440
208-359-3020
ub@rexburg.org
XBP Confirmation Number: 16598661
Transaction Number: 50138897PT
Visa — XXXX-XXXX-XXXX-9941
Status: Successful
Account # Item Quantity Item Amount
Mechanical Permit 1 $65.00
Notes: Permit 16-00294
TOTAL:$65.00
Transaction taken by: stevenp
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1 of 1 4/13/2016 4:42 PM