HomeMy WebLinkAboutAPPLICATION - 17-00215 - 525 S Center St - Austin Building - HVAC ImprovementsCITY OF
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America's Family Community
BUILDING APPLICATION
Mechanical
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. Property Owner
Name: BYU-Idaho
Address: 525S Center City: Rexburg State: Idaho Zip Code: 83460
Phone & Type: 208-496-1411 El 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 El No: This property is a Multi -family Residence or Commercial Property.
NOTE: Any contracmrs/sub-contractors involved will need to submittheir own signed applications.
2. Mechanical Contractor
Name: Lewis Corporation Registration #: HVC-C-4440 Exp.:
Address: 15136 W Hunziker Rd City: Pocatello State: Idaho Zip Code: 83202
Phone & Type: 208.238.1202 ElOffice ❑ Mobile Email: kenyan@lcorp.com
Contact/Rep. Name: Kenyan Lewis Phone: 208.238.1202 Email: kenyan@lcorp.com
Mechanical Contractor Authorized Signature: Date: z
3. Project Description
Address: BYU-I Austin Building Renovations -OR- Lot #: _ Block #: _ Subdivision:
Check one: ❑ Single-family Residence ❑ Multi -family Residence El Commercial
Check one: ❑ New Construction* ❑ Remodel ❑ Addition ❑ Basement Finish
Description of work: HVAC Improvements
New Commercial Work: Contracted amount: $181563.00 Calculated Fee (See Below): $1567.82
O Up to $10,000 = (total cost of system x.02) + $60 ❑ $10,0014100,000 = ((total cost of system -10,000) x.01) + $260
El 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. = $19S ❑ 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 ❑ Fireplace/Solid Fuel Burning Unit= $65 ❑Technical Service = $65/hour
❑ Plan Check =10% of Contracted Amount
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, l hereby certify that l have read this application and state that the information herein
is correct and 1 swear that any information which may hereafterbe 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 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 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): Kenyan Lewis SiZedl:ectum
Date: April 24, 2017
Inspections must be called in before SAM on the day the inspection is requ requests called in after SAM will be scheduled for the next business day.
Inspection Hotline -(208)372.2344 www.mxburg.org Permit Technician -(208)372.2341 Revised March, 2016