HomeMy WebLinkAboutAPPLICATION - 16-00736 - 79 S 5th W #50 - Trailer Electrical HookupC I TY OF Building Safety Department
c REXBURG City of Rexburg
Su6mit ey Email
35 North tat East
Amnrtrrt't Fm,hgcem„'u"in' Rexburg, Idaho 83440
BUILDING APPLICATION
Electrical
For Office Use
Permit Number: (6'ooTS 6 Permit Type: ❑ New ❑ Remodel ❑ Addition ❑ Basement Finish
Fees Paid: ETYes ❑ No
1. Property Owner
Name; Doug Smith
Address: lG- 5"N, 5D City: Rexburg State: Idaho Zip Code: 83440
Phone & Type: 208-359-2617 ❑ Office El 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)
El No: I am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property.
NOTE: Any contractors/sub-contractors involved will need to submit their owns signed applications.
2. Electrical Contractor
Name: Leishman Electric Registration #: 1:30 -3 Exp.:1 i lip
Address: "VA2 S- �V"6. City: Rexburg State: Zip Code:
Phone & Type- 208-356-3770 ❑ Office ❑ Mobile Email: leishmanelectric@yaboo.com
Contact/Rep. Name: Eron Leishman Phone: 208-39 1433 Email:
Electrical Contractor Authorized Signa Date:
3. Project Description
Address: skyline Trailer Court #50 OR- Lot #: _ Block #: _ Subdivision:
Check one: D Single-family Residence ❑ Multi -family Residence ❑ Commercial
Check one: ❑ New Construction* []Remodel ❑ Addition ❑ Basement Finish
Description of work: Wailer hookup
New Commercial Work: Contracted amount: $ Calculated Fee (See 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 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: ❑ 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 branch circuits))
Miscellaneous: ❑ Small Works (work costing less than $200 with no change in service connections)=$10(needs no inspection.
❑ Central Heating/Cooling Systems= $65 ❑ Spas, Hot Tubs, and Swimming Pools= $65 1? Requested Inspection= $65
❑ Pumps -Water, Irrigation, Sewage (per motor) = ❑ $65 up to 25HP '❑ $95 26- 200HP D $130 over 200HP
❑ Irrigation Machine= $65 for center pivot+ $10 per tower of drive motor $ []Technical Service= $65/hour
❑ Temporary Amusement= $65 + $10 per ride, concession, or generator $ ❑ Plan Check =10% of Contracted Amours
❑ TenoporM Construction Services ONLY= $65 200 amp or less. One location for less than 1 ear.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofpedury, i hereby certify that l have read this application and state that the information herein
is correct and I swear that any infonnationwhich mayhemafterbe given by me in hearings before the Planning and Zoning Commission orthe City Council forthe City ofkexhurg
shall be truthful and correct. I agree to comply with all City regulations and State laws relating to the subject matter ofthis apphcation 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 ofthe 2012
International Code in cases ofanyfalse statement ormisrepresentation of fact in the application or on the plgs on whichthe permit orapproval was based. Permitvoirldnot
started wi0dn 188 days. Permit void if work stops for 185 day
Applicant's Name (print): br,0 Signature d r Date
Inspections most be called in before 8 AM on the day the inspection is requested. Inspection requests called inafter 6 AM will he scheduled for the next business day.
Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March, 2016