HomeMy WebLinkAboutAPPLICATION MECHANICAL - 16-00599 - 285 S 1st W - Kimball Remodel Rooms 170, 244, 250OQ p6xuUpC
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BUILDING APPLICATION
Mechanical
Building Safety Department
City of Rexburg
35 North 1xt East
Rexburg, Idaho 83440
For Office Use ' n
Permit Number: t� —�U q Permit Type: ❑ New CfRemodel ❑ Addition ❑ Basement Finish
Fees Paid: it Yes ❑ No
1. Property Owner
Name: BYU-Idaho
Address: 525S Center Street --City: Rexburg — State: Idaho Zip Code: 83460
Phone & Type: 208.496.9300 ❑ Office ❑ Mobile Email: _
Under Idaho Building Code, a homeowner is allowed to do work on their awn home.
Are you a homeowner doing work on your own home? ❑ Yes (Skip to #3 and complete the Homeowner's Exemption page)
❑ 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. Mechanical Contractor
Name: Lewis Corporation Registration #: HVC-C-4440 _ Exp,; 5-31-19 _
Address: 15136 W Hunziker Rd City: Pocatello State: Idaho Zip Code: 83202
Phone & Type: 208.238.1202 ❑+ Office ❑ Mobile Email: kenyan@lcorp.com
Contact/Rep. Name: Kenyan Lewis Phone: 208.1202 Email: kenyan@lcorp.com
Mechanical- Contractor Authorized Signatures Date: 10-21-16
3. Project Description
Address: BYU-I Kimball Building IT -OR- Lot #: _ Block #: _ Subdivision:
Check one: ❑ Single-family Residence ❑ Multi -family Residence ❑ Commercial
Check one: ❑ New Construction* O Remodel ❑ Addition ❑ Basement Finish
Description of work: Upgrade HVAC
New Commercial Work: Contracted amount: $ 21072.00 Calculated Fee (See Below): $ 370.72
❑ Up. to $10,000 = (total cost of system x.02) + $60 10 $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 HVAC fixtures)) $
Miscellaneous: ❑ Gas Pressure= $65 ❑ Furnace or A/C = $65 ❑ Water Heater = $65 ❑ Requested Inspection= $65
❑ Gas Line = $65 ❑ Fireplace/Solid Fuel Burning Unit= $65 ❑ Technical Service= $65/hour
❑ Plan Check =10% of Contracted Amount
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Underpenalty ofperjury,I hereby certify than 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 CoundI 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 ofthis application and hereby authorized representatives of the
City to enter upon the above-mentioned property for inspectors purposes. NOTE: The building official may revoke a permit on approval issued under the provisions ofthe 2012
International Code in cases of any false statement or misrepresentation offact in the application or on the plans on which the permit or approval was based. Pennitvoidifnot.
started within 180 days. Permit void ifwork stops for 180 days.
Applicants Name (print): Kenyan Lewis Signa _ Date: 10-21-16
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM will be scheduled for the next business day.
Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March, 2016