HomeMy WebLinkAboutAPPLICATION - 17-00006 - 765 N Yellowstone Hwy - Pedestal 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 Electrical 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. Electrical Contractor Name: _____________________________________________________________ Registration #: _________________________ Exp.: _______________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: ___________________________________ ⧠ Office ⧠ Mobile Email: __________________________________________________________ Contact/Rep . Name: ______________________________________ Phone: _________________ Email: ______________________________________________ Electrical 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 branch circuits)) $__________________ Miscellaneous: ⧠ Small Works (work costing less than $200 with no change in service connections)=$10(needs no inspection.) ⧠ Central Heating/Cooling Systems = $65 ⧠ Spas, Hot Tubs, and Swimming Pools = $65 ⧠ Requested Inspection = $65 ⧠ Pumps - Water, Irrigation, Sewage (per motor) = ⧠ $65 up to 25HP ⧠ $95 26- 200HP ⧠ $130 over 200HP ⧠ Irrigation Machine = $65 for center pivot + $10 per tower of drive motor $_____________ ⧠ Technical Service = $65/hour ⧠ Temporary Amusement = $65 + $10 per ride, concession, or generator $__________ ⧠ Plan Check =10% of Contracted Amount ⧠ Temporary Construction Services ONLY = $65 (200 amp or less. One location, for less than 1 year.) 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: _______________