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HomeMy WebLinkAboutAPPLICATION ELECTRICAL 2 - 16-00044 - 525 S Center - 2nd E Parking - BYUICITY OF REXBuxu '•.,, .,• .imerirn: Family Com ... ...... —r Submit By Emall BUILDING APPLICATION lnlmrical Duilding aafeiy uepartmenr City os tcexburr, 35 North 1-1 East Rexburg, Idaho 83440 1'.,7 Vire. uzie Pc. mitN'amber: Permit -type: u Ne.. ❑ Rzmodci 13 Addition u ilasement Finish rees PaiO: Gies G Ivo .L. rroperty Vwner Name: BYu-launo Address: — r gn i:sti3=r x'+ City: F e ../s f __' State: ID Zip Code: 83460-BZUS Phone az T ype. (209) 496.2665 I7 vfl'ice ❑ mobile email:e. ark@byuLud-a under inano tsuiltiing Cone, a nomeowner is anoweu to Co worK on Meir own nome. nre you a homeowner floing warK on your own homes ❑ les (3Kip 10 Its ane complete Me nomeowner's Exemption page) ❑ No: 1 z eo;;tr..etor ,.v.—I1L—s Iva me n.mev ;.:cr EI No: 1 M3 proyerty 1., u Multi-L.ah, Rc :aea.ce o, Cv- vrc-k;1 Pa operty. Na_,..ny znr,;kzd sill need ripply.-.tl....s. z. Clectrical Contractor ivame. Regisu ation ti: ELE-C-3802 Exp.: 12/31/16 Address: Y �v �'I jh-,r _,tr , -T 1 City: � I r7 fu f -t State: ID Zip Code: 83221 rnone M type: (208) 684.5463 EI vulce © iviouile r mah .ien�en@me.- e�«le�.even Contacr/nep. Name: scot ..anstrom rnone: R08j 684.5463 Gmail., srranstroml mtnwesteleccom ElerMical Conu actor Authorized Signature: l �+ Date: 9/12/2016 3. Project Description Address: 2-d East Papkin;; Lot -OR- Lot #: -� Block #: „v- Subdivision: CnecK one: ❑ 3ingie-lamhy nesillence 17 multi-minhy nesiDence XCommerciai CnvcK v.ic: ❑ Ne.. Co...•traGtip..* ❑ Kcm.Clcl ❑ Ana,tien .5cm,;-it t-i.i,n llc3..-, t:o- of -o. K: New Commercial Work: Contta�ted amount: $ 109,500.00 Calculated Fee (See Below): $ PAID BY GC ❑ up Lo $10,000 = (total cost of system x,02) T $60 ❑ $10,001-$100,000 - ((total cost of system -10,000) x.01) T $260 E3 V:e. 3100,001 = ((total wo-t er 3ynte--1u0,u17171 .005 + 3,1,160 new Single -Ramify ResiRential vvorR: 3q. rt. ❑ up to 1,50u aK. FC = 31sI3 ❑ 1,5171-�,a017 �Y. rC = 31y5 ❑ c,5u1-s,500 3ti. rt. _ �ZSu D s,501-�F,300 aM.1-r = 33L5 ❑ Over 4,305 3q. rt. = $3Z3+(63 x tf of anidonal L,'uhh 3q. re (or portion thereof)) $ New Muli:.-Family Residential: ❑ Duplex= $260 ❑ Three or more units= $((130 x # of buildinrs)-(65 x # of units))$ New work on any other residence and Detached Shops; = $(65 r (10 x # of branch circuits)) $ miscellaneous: 0 Small worlts _LworK costing less roan $cuv wiu-t no cnange in service connections)=$i'u(neells no inspection. ❑ Centt al Heating/Cooling Systems = $65 ❑Spas, Hot Tubs, and Swimming Pools = $65 ❑ Requested Inspection = $65 D r�-r . - vv..t=r,1..-Ig..tiea., Se :a6e gip=..-eier� = Q 3S5 �P to a3rtr ❑ 3y5 c6- cQunr ❑ 31s0 over c0'urtr U Irrigation Machine = $65 for center pivot+ $10 per tower of drive motor $ ❑ Technical Service = $65/hour l � yy A.a.t13c.:.e.�.i = $�5 r $1l) t,t :.�iac, ca.:ec�3ivl1, a: gcrrerwCo� $, _. CI r1u11 Cr1ccK =1O9I0 oI Co;.C.��eCca Am.ow.: t emporaEy Construction Services Un L. t = $ISS CtrjU amn or less. 'One locaiton ror less Ulan L year.1 APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Und.r pen..Ity.Fp.dzry, I hereby ee .lfy :h -.I rnd.=e.:h-. the L -.form eon herein :s correec...d I s u...:ha:.ny inf .—..um. which m..y here..Rerbs gi ',-. by . In he..ringa before .he t'1»,-.,-.Ing.nd Z.ni..g Com 371or. or :he City Council F r th. Cityof ii.c;;berg sl;a:: we e, :Ileal.00 evreErc. I ag. a t.. eomp.y - . —City EgOl.7e.m an. 3M.'aw. i applicatm a :;.reby .u.'o,.zed rep—nano.—. t,.',e city to cntcrap.r. tR! a� .ve-.�,ei..�orew p,�per,y mr I,=spe.ttons porpases. Rv i E: Toe Lniloing omd,l m,y,'evo_1e1 permil o" appro7..1 issraeo nnoe, 'INC p,-osfsiom Orel -IC ZeiZ Internatlunal C.ue in....es uf.,ny f..ne siatcmem or misrep, mcnratiun of r.,tt,n iM appllwtiun or un tM plans un wlli,R tRc p.r,iir ur appruv..1 w..s Z -.u. F.rmit voiu if nut started within 180 days Permit void ifwork stops for 183 days. Applicant's Name (print): Al,.i-i.tt,..n Signature: Date: 9/12/2016 L._pctlom mmt be roiled i= b.for.8 AM._. the d-, t1= I_.e,-.Sita f_ n9murted. Inep.dl-e _ _v__t_ welled le _ftrt a AM rill be:■I:.d_I_d F._ the :_ct b -1.__e & Inspection Hotline -12o.j 372.2344 www.re.borg.vrg P.rmit TeLhnkl..n - IZva1 372.2341 Revised March, 2016