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Home My WebLink AboutALL DOCS - 16-00606 - 2503 S 1420 W - County Furnace and AC 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 Revised March, 2016 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 BUILDING APPLICATION Mechanical For Office Use Permit Number: ____________________ Permit Type: ⧠ New ⧠ Remodel ⧠ Addition ⧠ Basement Finish Fees Paid: ⧠ Yes ⧠ No 1. Property Owner Name: ___________________________________________________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: _______________________ ⧠ Office ⧠ 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? ⧠ Yes (Skip to #3 and complete the Homeowner’s Exemption page) ⧠ No: I am a contractor working for the homeowner ⧠ No: This property is a Multi-family Residence or Commercial Property. NOTE: Any contractors/sub-contractors involved will need to submit their own signed applications. 2. Mechanical Contractor Name: _____________________________________________________________ Registration #: _________________________ Exp.: _______________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: ___________________________________ ⧠ Office ⧠ Mobile Email: __________________________________________________________ Contact/Rep. Name: ______________________________________ Phone: _____________________ Email: __________________________________________ Mechanical Contractor Authorized Signature: ____________________________________________________________________ Date:________________ 3. Project Description Address: _______________________________________ -OR- Lot #: ____ Block #: ____ Subdivision: _________________________________ Check one: ⧠ Single-family Residence ⧠ Multi-family Residence ⧠ Commercial Check one: ⧠ New Construction* ⧠ Remodel ⧠ Addition ⧠ Basement Finish Description of work: _____________________________________________________________________________________________________________________ New Commercial Work: Contracted amount: $________________________________ Calculated Fee (See Below): $__________________ ⧠ Up to $10,000 = (total cost of system x .02) + $60 ⧠ $10,001-$100,000 = ((total cost of system -10,000) x .01) + $260 ⧠ Over $100,001 = ((total cost of system -100,000) x .005) + $1,160 New Single-Family Residential Work: _________ Sq. Ft. ⧠ Up to 1,500 Sq. Ft. = $130 ⧠ 1,501-2,500 Sq. Ft. = $195 ⧠ 2,501-3,500 Sq. Ft. = $260 ⧠ 3,501-4,500 Sq. Ft. = $325 ⧠ Over 4,500 Sq. Ft. = $325+(65 x # of additional 1,000 Sq. Ft. (or portion thereof)) $_________________ New Multi-Family Residential: ⧠ Duplex = $260 ⧠ Three or more units = $((130 x # of buildings)+(65 x # of units))$_____ New work on any other residence and Detached Shops: = $(65 + (10 x # of HVAC fixtures)) $__________________ Miscellaneous: ⧠ Gas Pressure = $65 ⧠ Furnace or A/C = $65 ⧠ Water Heater = $65 ⧠ Requested Inspection = $65 ⧠ Gas Line = $65 ⧠ Fireplace/Solid Fuel Burning Unit = $65 ⧠ Technical Service = $65/hour ⧠ Plan Check =10% of Contracted Amount 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: _______________ Permit Inspection Summary Permit Status of (Issue) as of Report Date: 03/09/2017 3:05 pm Permit Details Permit Number: 16-00606 2503 S 1420 W - County Furnace and AC 2503 S 1420 W Madison County Mechanical Residential Permit Issued Date: 09/20/2016 Permit Inspection Statistics 2Total Inspections Completed: 2Total Inspections Passed: Inspection Pass Rate 100.00% Permit Inspection History *Refer to Individual Inspection Report for more Details Mechanical Inspection Type 09/21/2016PassDon AllenHVAC Rough-in Good to cover the mechanical rough in Gas pressure held at 20 lb Inspector Comments: 02/02/2017PassDon AllenHVAC Final Inspection Good fore the C/OInspector Comments: Transaction detail for payment to City of Rexburg. Date: 09/20/2016 - 4:49:40 PM Billing Information Hallco Heathing Hallco Heathing , 83406 heatman1958@gmail.com Transaction Details City of Rexburg 35 N 1st East | PO Box 280 Rexburg, ID 83440 XBP Confirmation Number: 21802492 Transaction Number: 57326326PT Visa — XXXX-XXXX-XXXX-8865 Status: Successful Account # Item Quantity Item Amount 16-00606 Mechanical Permit 1 $130.00 TOTAL:$130.00 Transaction taken by:markd Email:heatman1958@gmail.com Xpress Bill Pay - Transaction Details https://secure.xpressbillpay.com/common/trans_details.php?trans_id=N... 1 of 1 9/23/2016 5:02 PM