HomeMy WebLinkAboutAPPLICATION - 17-00380 - 322 Oaktrail Dr - AC AdditionJul 11 1706:44a Alpine Heating Air
of 4�aot�
n'' At3 IT Y OF
REX.BURG
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Aoanlm3 Family Cnmmumo,
BUILDING APPLICATION
Mechanical
2085520594 p.1
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
Foir 00ice Ilse'.:
Permit Number: Permit Type. ❑ New '❑ Remod'el TIAddition. ❑ Basement Finish
,.
Fees Pa1d . O:Yes ❑ No .
1, Prope,E4 Owner
Name: B>^ ��]`�
Address: 2 City: D State:
._ Zi Code:
P
Phone &Type3 27,2- X78 ❑ 0fficeEPMobi Ia 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)
J21KD: I am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property.
NOTE: Any contrsctni s/sulucontrattors hwolved will need to submit their nvm signed applications.
2,Mecha icalContractor t
_
Name: Registration #: % - aS 9 Exp.:
Address: City: _ T el state: T
_ �_Zip Cod e: OZ
Phone &Type: S 0 Office ❑ Mobile Email:
Contact/Rep. Name: A Phone: Email:
Mechanical Contractor Authorized Signature: Date:
3. Project Desert
Address: pti n' r.0
R- Lot #: _ Block #: _ Subdivision:
Checkone: mangle -family Residence ❑Mu
'-family Residence ❑Commercial
Checkone: ❑ New Construction` Remod
1 ❑ Addition ❑ Basement Finish
Description of work:
New Commercial INork: Contracted amount: $
Calculated Fee (See Below): $
❑ Up to $10,000 = (total Cost of systemx.02) + $60
❑ $10,0014100,000 = ((total cost of system -10,000) x.01) + $260
❑ Over $100,001=((total cost of system -100,00
)x.005)+$1,160 '
New Single-FamilyRe:siddntial Work: Sq,
Ft.
❑ Up to 1,500 Sq. Ft. = $11P0 O 1,501-2,500 Sq.
t = $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 thereol)) $
New Multi -Family Residejltial: ❑ Duplex = $260
❑ Three or more units = $((130 x # of buildings)+(65 x # of units))$_
New work on any other r$sidence and Detached b
lops: _ (65 + (10 x # ofHVAC fixtures))
Miscellaneous: ❑ Gas Pressure = $65 XFurnaeor.A
C=$65 ❑ water Heatere: $65 ❑ Requested Inspection =$65
❑ Gas Lite = $65 ❑ Fireplice/Solid
Fuel Burning Unit= $65 ❑ Technical Service = S65/hour
❑Plan Check =10% of Contracte
I Amount
APPLICANTS SIGNATURE, CCRTIFICATION AND AUTHORIZATION:
is correct and Iswear that any information which may hereaRerbe
shall be truthful and correct. 1 agree''to comply with all cityregulatl
qty to enter upon the above-mentioned property for Inspections pe
International Code in cases ofany false statement or mfsrepretentai
started within 18D days. Permit sof arks tops for 180 days.
Applicants Name
Inspec dons must he called In before8 AM entire day the
Inspection Hotline -(2081372.2344 www:
N
ter penalty of perjury, I hereby certify that 1 have read this application and state that the Information herel n
n by me In hearingsbefora the Planning and ZontngCommission or the City Council Forthe Cltyof Rexburg
and State laws relating to the subject matter ofthis application and hereby authorized representatives of the
.as. NOTE: The building afficlal may revoke a permit on approval issued under the provisions ofthe 2012
offact in the application ar on the plans on which the permit or approval was based. Permitvaidifnat
signature: CX.
lion is requested. Inspection requests called In after SAM will be scheduled for the nextbusiness day,
rg.org PermitTechniclan—(208)372.2341 Revised March, 2016