HomeMy WebLinkAboutAPPLICATION - 17-00069 - 3232 W 1000 N - New County SFR MechanicaloF�apaR�
5;sCITY OF Building Safety Department
�G BUILDING PERMIT FORM 110 City of Rexburg
t" np"W10'3016 35 North 1st East
.,�10 • Atneriza's Fxonfjy Community
Rexburg, Idaho 83440
BUILDING APPLICATION
New SFR Mechanical
I. Property Owner
Name:
Address:�8�3 a W I OC.Q N City: �� State: l_ Zip Code:83440
Phone: Y>h ,31� 3D3 Email J A n
V, ft _
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)
No, I am working with the homeowner
2. Mechanical Contractor
Business:YV\O�or` d p State License #: iS a Exp.: 5)0\ $
Address: E City:State: M _ Zip Code:.93 y 4�
Phone: 2i7 7y3--1O�) a(i ���'c o 02 laY� t Y-�✓L
Contact/Rep. Name: !t w l Phone: 713 r Email:
Jill
A copy ofyour state registration/license is required Date:
to be file. If this is thefist timeyou have done work in the City of Rexburg, please provide
a photo copy ofyour license lfyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
3. Project Description
Address: 3,122• W I -OR- Lot #: _ Block #: _ Subdivision:
Description of work: tN\ 04(— Me'Ak
SFR Construction: c2D _sq, ft'�
• Feesfor new construction are charged by square footage: Up to 1,500 sq. ft = $130 +$65 for each additional 1,000 sq. ft or
portion thereof
o Up to 1,500 sq.ft = $130. Up to 2,500sq.ft=$195.Upto3,500sq.ft=$230. Up to 4,500 sq, A = $295, etc. (i.e. a home
with 3,675 sq. ft will be charged $295)
ANumber of Fireplaces: I_
• Note that fireplaces are not included in square footage costs and will be charged $65 per inspection.
❑ Hydronic Heating:
• Note that hydronic heating is no t included in squarefootage costs and will be ch arged and additional $65 + ($10 x # of
APPLICANTS 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 men that any Information which may hereafter be given by mein hearings befor@@ the Planning and Zoning Commission or the City Council for the City of
Rexburg shall be truthful and coma t agree to comply with all City regulations and State laws relaring�the subject matter of this application and hereby authorized
representatives ofthe City to enter upon the above-mentioned property for inspections purposes. NOT 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 offactin a application or on the plans on which the permit or approval was
based Permit void if not started within 180 days. Permit void lfwork stops for 180 days.
Applicant's Name (print):
Inspections must be called in before 8 AM on
Inspection Hotline - (208) 372.2344
ate: Ci I
B AM will be scheduled for the next business day.
Permit Technician - (208) 372.2341