HomeMy WebLinkAboutAPPLICATION - 16-00502 - 4474 Cedar Butte Rd - County Mechanical OnlyAlpine Healing Air
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Submit By Email
BUILDING APPLICATION
Mechanical
2085520594 p.1
Building Safety Department
City of Rexburg
35 North 1st East
RexbUCF. Idaho 83440
For Office Use
Permit Number: Permit Type: ❑ New ❑ Remodel []Addition ❑ Basement Finish
Fees Pafd: []Yes ❑ No
1. Property' Owner
Name: l f 1, ✓
Address: city1 �� _ State: _T6 Zip Code: B S D
Phone&Type: !W'1 -19Q1 ❑ OfffcegMobile 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 Homeowners Exemption page)
No: I am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property,
NOM Any contractors/sub-mnt acmrs involved will need to submittheirown signed a pphtatinns.
2. Mechanical Contxattor
Name: amine Haating&Air Conditioning Registration Hvac-c-3258 Exp:
Address: 170N. Eastern AveIdaho Falls
City: State: ID Zip Code: 83402
Phone&. Type: 208-523-5542 I]Office ❑Mobile Email: fm@alpineheatingair.com
Contact/Rep. Name: Paula Anderson —�� Phone; 208423-5542 Email: paula@alpineheatingair.com
Mechanical Contractor Authorized Signature: 'Tot�_�a�� jl— Date:
3. Project =P'M �chi ^s ti p r
Address: Lot #: _Block #: _Subdivision:
Check one: ❑ Single-family Residence ❑ Multi -family Residence ❑ Commercial
Check one: ❑ New Construction* Remodel M Addition ❑ Basement Finis
Description of work:
New Commercial Work: Contracted amount: $ UCalculated Fee (See Below): $
❑ Up to $10,000 = (total costof 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 uvork on any other residence and Detached Shops: _ $(65 + (lox
# of HVAC fixtures)) $
Miscellaneous: ❑ Gas Pressure = $65 ❑ Furnace or A/C = $6S ❑Water Heater = $65 ❑ Requested Inspection ee $65
❑ Gas Line = $65 ❑ Fireplace/Solid Fuel Burning Unit = $65 ❑ Technical Service= S65/hour
❑ Plan Check =10% of Contracted Amount
APPLICANT'S SIGNATURE, CCRTIFICATION ANDAUTHORIZATION: Under penalty ofperjury, I hereby certify that I have read this application and state that the Information herein
is correct and t swear that any Information which may hereafter be given by mein hearings before the Planning and Zoning Commission orthe City Council for the Cityof Rexburg
shall be truthful and correct. 1 agree to complywith all City regulations and State lases relating to the subject matter of this application and hereby authorized representatives of the
cityto, emerupon the above-mendowd propertyforinspections purposes. NOTE: The building ofacial may revoke a permit on approval issued under the provisions ofthe 2012
International Cade in roses of any false statement or misrepresentation of fact In the application oran the piens on which the permit or approval was based. Permit void if not
startedwithin3BOdays. Permit void irworkstops for SED d )5.
Applicant's Name (print): i GESd'$ignature:
Date: 8
Inspections must be called mbefere 8 AM on the day the Inspection is requested. Inspection requests called in after B AM will be scheduled for the nestbusiness day.
inspection hotline -[209)372.2344 www.rexbure.org Permit Technician -(208)372.2341 Revised March, 2016