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HomeMy WebLinkAboutAPPLICATION - 17-00317 - 2287 W 4200 S - Heat PumpC I TY OF REXBURG 04 Amerieds Family Community Building Selfety Department Submit BCity of Rexburg y Finail 35 North 15t East Rexburg. ld;ihn W�440 BUILDING APPLICATION Mechanical For Office Use Permit Number: Permit Type: ❑ New 0 Remodel []Addition ❑ Basement Finish Fees Paid: ❑ Yes ❑ No 1. Property Owner Name: "-Z 41V ��sl Address: zLt `l Y2&'0 J City: /���iti;�_ State: �� Zip Code: Phone &Type. 3S`/— `7j;r3X p Office ❑ Mobile Email: Cinder 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) ONO: I am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property. NOTE:: Anycontramrs/sub-contractors involved will meed to submit their own signed applications. 2. NleCllan�,,Con t r Name:%'!%G1,7 f1� 0 C Re istr tion #: �l �✓�- -r fj ExpAddress: - City: q f d✓ E l/ State: D Zip Cade: 3 '� ©S� Phone Si Type: 2!? �i $'S S -9- 6P $ _— l ffice ❑ Mobile Email: � � �fJ C'� 111,!P yki a 1J ke &+foo e'e A -j Contact/Rep, Name: /Y4'ry Phone: -Fri - Email: Mechanical Contractor Authorized Signature-`°/ 3. Project Description Address: ZZZ S / L0 -OR- Lot #: _ Block #: _ Subdivision: Check one: L? Single-family Residence ❑ Multi -family Residence ❑ Commercial Check one: ❑ New Construction* ITm''Remodel 0 Addition ❑ 3asement 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: Ll 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 13 Gas Line = $65 Fireplace/Solid Fuel Burning Unit= $65 ❑ Technical Service= $65/hour ❑ Plan Check =10% of Contracted Amount n rwuu iii aaiurvaiuxr,,LVIKIIPICA-1-10NAND 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 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 ofthe 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 rases of any false statement or misrepresentation cffact in the application or on the plans on which the permit arapproval was based. Permit void if not startedwithin180days. Permit void ifwarkstcpsfor ISD days. AppIicant's Name (print): r AIL)'_ y Signature: Date: lz C Inspections must be called in before SAM on the day the inspection is requested. Inspection requests called in after SAM will be scheduled for the nextbusiness day. Inspection Hotline - (208) 372,2344 wwwzexburg.org Permit Technician - (208) 372.2341 Revised March, 2016