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HomeMy WebLinkAboutAPPLICATION - 17-00318 - 624 Sunflower Rd - AC InstallQ4 > x°Vt C CITY O F Building Safety Department r7 REURG City of Rexburg � Submit By Email 0 35 North 1St East '•,,FTeo Americ6Family CemmuniV 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: G .J 14%0 - 0 Address; k2 V .T� kn ou,,e,r City: +-6 State: ­7 Zip Code: Phone & Type: Y _ 7T2d ❑ 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) JP No: I am a contractor working for the homeowner 0 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. Mecham 1 Contract r Name: /I 1.60 �C Registration #: �' — — ✓� Exp.: Y-7 Address: ' 212 y� _f ,l')— City: f'�Idkf-€' l t State: -470 Zip Code: 43 0.5-- Phone & Type: C2_0 5_ 516P 9 [ ffice ❑ Mobile Email: _ � I*1 Cf I� I7�v1©w h et feGD /. �e Contact/Rep. Name: Ze4��y Phone: -S � Email: Mechanical Contractor Authorized Signature: Date: 3. Project Descriptio Address: (e,2-,Z '✓I lvl✓Y'•' � -OR- Lot #: _ Block #: _ Subdivision: Check one: Wingle-family Residence ❑ Multi-family Residence ❑ Commercial Check one: ❑ New Construction* ❑ Remodel ❑ Addition ❑ Basement Finish Description of work: 11�x/ C_ - New Commercial Work: Contracted amount: $ 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. 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 0 Fireplace/Solid Fuel Burning Unit= $65 ❑ Technical Service= $65/hour ❑ Plan Check =10% of Contracted Amount APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury, 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 PIanning 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 an approval issued under the provisions of the 2012 International Code in cases of any false statement or misrepresentation offact 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 workstops for 180 days. Applicant's Name (print)x%�4� >? Signatur Date: fr Inspections roust 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.rexhurg.org Permit Technician — (208) 372.2341 Revised March, 2016