HomeMy WebLinkAboutAPPLICATION - 17-00063 - 313 S 3rd E - FurnaceFeb 1517 09:00a Alpine Heating Air
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0 4�� CITY OF
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REXBURG
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BUILDING APPLICATION
Mechanical
2085520594 CA
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
For Office Use
PermitNumbeer/r: (7-n°o63 Permit Type: ❑New ❑Remodel ❑Addition ❑Basement Finish
Fees Paid: Vyes ❑ No
1, Property 0wrier
Name: h2A ur —� �J
Address: �J �i_g -�` City: State: 1Zip Code: 5K
Phone &Type: 754 7r173 ❑ Off ce ❑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)
KIo: I am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property.
NUTS: Any contra cmrs/sub.contraaum involved will need to suhmir their own signed applicntio ns.
2. Merin n•cal Cont
or
Name �f 4a_lw sac/ l_onN- Re is ation #: Com_; g Exp.:
Address: �� e _]ws ,A. City J1 State:Zip Code:
C�2
Phone &Type: a,�SS �'Z 1a Office ❑ Mobile Email:
Contact/Rep. Name I Phone: Email: r�
Mechanical Contractor Authorized Signature CiL�. Or.��,1.+sf� Date: 7
3. Project Description
Address: -515 S . aA4'F -OR- Lot #: —Block #: _Subdivision:
Check one: ❑ Single-family Residence ❑ Multi -family Residence ❑ Commercial
Check one: ❑ New Construction` JP4emodel .❑ Addition ❑ Bas ment Finish
Description of work: t ` Ra a
New Commercial Work: Contracted amount: $ alculated Fee ee 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 costof system -100,000) x.005) + $1,160
New Stngle-familyResidentiMWork: Sq. Ft.
❑ Up to 1,500 Sq. Ft. = $130 C 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-Farnfly Residential: ❑ Duplex= $260 ❑ Three or more Units= S((130 x # of buildings)+(65 x # of units))$_
New work on any other residence and Detached Shops: = $(65 + (lD x # ofHVAC fixtures)) $
Miscellaneous: ❑ Gas Pressure = $65 .K_Furnace orA/C = $6S ❑ Water Heater = $65 D Requested Inspection= $65
❑ Gas Line = $65 ❑ Fireplace/Solid Fuel Burning Unit= $65 0 Technical Service= $65/hour
❑ Plan Check =10% of Contracted Amount
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APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certiF, that I have read this application and state that the information herein
Is correct and I swearthat any Information whlchmay hereafterbe given by me In hearings before the Planning and Zoning Commission orthe City Council for the Cityof Rexburg
shall be truthful and to rrect. I agree he comply with all City regulations and State laws relating to the subject matterof this application and hereby authorlmd representatives ofthe
City to enterupo n the shove -mentioned propertyfor 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 fake statement or misrepresentation offset in the apPliwtion or on the plans on which the permit or approval was hosed. Permit void iFnot
started within 180 days, Portal: void if workstops for 180 days.
ApplicanCsName (print)-fit� Signatur. e. Date: /
Inspections must he called in before SAM oft the day the Inspection is requested. Inspection requests called in after 8 AMtvill be scheduled For the next business day.
Inspemon HPHine-;208)372.2344 w•.vw.rexburg.org PermitTechnician-(208)372.2341 Revised March, 2016