HomeMy WebLinkAboutAPPLICATION ELECTRICAL - 16-00599 - 285 S 1st W - Kimball Remodel Rooms 170, 244, 250g Safety P
CI � Y o I~ Buildin Safe Department
Cid of Rexburg
'
RE)MURG Submit By Emal1
A -W 35 North 1St East
~'s,: Arnerf sFamilyCommunity Rexburg, Idaho 83440
BUILDING APPLICATION
Electrical
For off ce ase
Permit Numel•: Permit Type: Ll New Remodel fl Addition C! Ilasemet Finish
Fees Paid: Yes C-1 No
1. Property Owner
Name: BYU-Idaho
Address: 6698 N. 25th E. City: Idaho Falls _ State: ID Zip Code: 83460
Phone & Type: 208-589-6826 ❑ Office El Mobile Email: rme@ida.net�_�
C Under. Idaho RWIding Code, a homeowner is allowed to dor work on their own ho=me.
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 own signed applications.
2. Electrical Contractor
Name: Rocky Mountain Electric Inc Registration #' ELE-C-18230 Exp,: 3/31/17
Address: 6698 N• 25th E. City: 1-daho Falls State: ID _ Zip Code: 83401
Phone & Type: 208-589-6826 ❑ Office ❑ Mobile Email: rme@ida.net
Contact/Rep. Name: Lee Boren Phone: 208-589-6826 Email: rme@ida.net
E —tri l Gontractior Authc ri ed Signature;: Lee Boren Date:10/25/2016
3. Project Description =.___–
Address: BYU-I Kimball Building -OR- Lot #: Block #: __-_ Subdivision:
Check one: ❑ Single-family Residence ❑ Multi -family Residence ❑ Commercial
Check one: 0 New Construction* ❑-Remodel ❑ Addition 0 Base hent Finish
Description of work: Remodel room& 170, 2,44,. & 25.0 of the.KimbaU building.
New Commercial Work Contracted amount: $ 92,K5.00 Calculated Fee (See Below): $1088.25
Up to $10,000 = (total cost of system x .02)'+ $60 E1$10014100,000 = ((total cast of system -10,000) x.01) + $260'
0 Over $100,001 = ((total cost of system 400,000) x.005) + $1,160
New Single -Family Residential orl(: 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
O Over 4,5130 Sq. Ft. = $325¢(65x.# ofa lditional 1,DD D Sq, Ft (car porti-on thereof)) $
New oiti-Fatt-�ily Residelitial. `fl Dul)lex = $260 '0 three or -more -units>- $ff130 x # ofbuiidinPsl+f65x ## of unitsll$
APPLICANT'S 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 swear that 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 relating to the subject matter of this application and hereby authorized representatives of the
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 of the 2012
International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the perrmit or approval was based. Permit void if not
started within 180 days. Permit void if work stops for 180 days.
Applicant's Name (print): Lee Boren Signature. Date: 10/25/16
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after S AM will be scheduled forthe next business day.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 Revised March, 2016