HomeMy WebLinkAboutAPPLICATION - 16-00600 - 135 S 2nd W - Meter Base ReplaceCITY OF
RMURG
Amcrfra's Family Community
BUILDING APPLICATION
Electrical
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use
Permit Number: Permit Type: ❑ New ❑ Remodel ❑ Addition ❑ Basement Finish
Fees Paid: ❑ Yes []No
1. Properq Owner
Name: 'IIIIlIt'Y'rl
Address: I jL I 2 S. '110 City: �lY Vl -State: -+A40 Zip Code: lJ�_
Phone&Type: �U—b)M10-6141- ,-0-Office❑Mobile Email: ,/�iVh%iiq (Dn'). (nVN
Under Idaho Building Code, a homeowner is allowed to do work on their own home\J
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 homeownerXNo: 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. ElectriI Contractor
Name: gistration #: Exp.:
Address: _ _ 6W16 ' b00 N City: _ tat
Se: J Zip Code: 930D
Phone &Type:' -An -.4424 ❑OfficeOMobil mail:
Contact/Rep. Name:N�jKA�{Ipl�f�ul� ho Z - E M
Electrical Contractor Authorized Signature: Date:
3. Project D c I on
Address: " -OR- Lot #: _ Block #: _ Subdivision:
Check one: Ingle -family Residence' ❑ Multi -family Residence ❑ Commercial
Check one: LJ New Constructions' ❑ Remodel ❑ Addition❑Basement Finish
Description ofwork:@ SL
New Commercial Work: Contracted amount: $ Ij Calculated Fee (See Below): $
❑ Up to $10,000 = (total cost of system x,02) + $60 ❑ $10,0014100,000 = ((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. FL
❑ 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 oil 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 Amoun
❑ TemporarV Construction Services ONLY= $65 200 amp or less. One location for less than 1 ear.
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 mein 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 officials r Permit on approval issued under the provisions of the 2012
International Code in cases of any fake statement or misrepresentation of fact in the application or epans Fytch the pm7 [ or approval was based, Permit void if not
started within 180days. Piifwk
Applicant's Name (print): Via VyS. Signature��Date:f u W
Inspections most be called in before 8 AM on the day the inspection is requested. Inspection requests called inafter 8 AM will be scheduled for the next business day.
Inspection Hotline -(208)372.2344 urvvwa'exburg.org Fin mit Technician -(206)372.2341 Revised March, 2016