HomeMy WebLinkAboutAPPLICATION - 16-00754 - 437 Linden Ave - Sewer LinerF48xa " CITY OF Building Safety Department
a =,G City of Rexburg
r Suhmit By Email
35 North 1st East
Americas BarNly Community Rexburg, Idaho 83440
BUILDING APPLICATION
Plumbing
For Office Use
Permit Number: Permit Type: ❑ New ❑ Remodel 0 Addition ❑ Basement Finish
Fees Paid: 0 Yes 0 No
1. Property Owner
Name: De6ble and Les Kortright
Address: 437 Linden Ave City: Rexburg State: ID Zip Code: 83440
Phone & Type: 3901354 0 Office 0 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? 0 Yes (Skip to It and complete the Homeowner's Exemption page)
E No: l am a contractor working for the homeowner 0 No: This property is a Multi -family Residence or Commercial Property.
N01'Ry1nY cmunnnrs/suircuulmttnrs ins id6ud will need m sobmu Ihcu own signed npphratGnu.
2. Plumbing Contractor
Name: Advaneed home Services Registration #: C5806 Exp,; 10/2017
Address: POB -249` City: Rigby State: to Zip Code; 83442
Phone & Type: 2087459406 ._EI Office 0 Mobile Email:
Contact/Rep. Name: Kip Sales Phone: 2087459406 Email: apsherric@gmail.com.
Plumbing Contractor Authorized: Signature: Kip Solas Dam;11/7/2016
3. Project Description Water Meter Quantity: Water Meter Size:
Address: -OR- Lot M _ Block #: _ Subdivision:
Check one: 0 Single-family. Residence 0 Multi -family Residence 0 Commercial
Check one: O New Construction* 0 Remodel 0 Addition Cl Basement Finish
Description of work:
New Commercial Work: Contracted amount: $ _ Calculated Fee (See Below): $
0 Up to $10,000 (total cost of system x .02) + $60 ❑ $10,0014100,000 = ((total cast of system -10,000) x.01) + $260
0 Over $100,001= ((total costof system -100,000) x.005) + $1,160
New Single -Family Residential Work:. Sq. Ft
0 Up to 1,500 Sq. Ft = $130 01,501-2,500 Sq. Ft = $195 0 2,501-3,500 Sq. FL.= $260 0 3,501-4,500 Sq. Ft = $325
0 Over 4,500 Sq. Ft = $325+(65x # of additional 1,000 Sq. Ft (or portion thereof)) $
New Muld-Family Residenbal:13 Duplex= $260 0 Three or more units= $((130 x # of buildings)+(65 x # of units))$_
0 Gray Water Systems= $130 0 Lawn Sprinklers/Backflow. device= $65 0 Multipurpose Fire Sprinkler & Domestic Water
Supply System = $65 or $4 per s rinkI r head (whichever is greater
New wont on any othm• residence and Dcrtched Shops: = 65
Mer and water stub connections 0
Miscellaneous: • Sewer Line = $65 13 Water Line = 65 ClSewer and Water Line= $65 ORequested inspection = $65
Cl Sewer Turnaround (septic to city) = $65 O Hydronic Heating= $65 + ($10 x # of manifolds/zones)
0 Technical Services: $65/hour 0 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 s elm that the information herein
Ls correct and 1 sw x rthat any information which may hereafter be 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 relatingto the subject matterofthis application and hereleyauthonxed represenmdves 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 ofthe 2012
International Cade In cases ofany false statement or misrepresentation of fact in the application gran the plans on which the permit or approval was based. Permitmid ifnot
started within 180 days. Permit void ifworkstops for 180 days.
Applicant's Name (print): Sherri Caspers Signature: Sherri A Caspers .Date: 11/7/2016
Inspections trust be called in before 8 AM on the daythe inspection is requested. Inspection requests called heafter8 AM will be scheduled for the nextbminess day.
Inspection Hotline -(208)372.2344 vnmv.mxburg.org Permit Technician -(208)372.2341 Revised March, 2016