HomeMy WebLinkAboutAPPLICATION - 16-00517 - 2237 E 3750 N - New County SFRC4oe oexeua�a CITY OF
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BUILDING APPLICATION
Mechanical
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use
Permit Number: 16-OOTI-f Permit Type: KNew []Remodel ❑Addition ❑ Basement Finish
Fees Paid: M Yes ❑ No
1. Property Ow
Name:
Address: City: v'f-4 State: _lw_ Zip Code: 47Vy 10
Phone & Type:; O S/ 4 6' ❑ Office Chile Email: 14
Under Idaho Building Code, a homeowner is al owed 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)
No: I am a contractor working for the homeowner O 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. Mech!09
Co •acG r ' � �il,,,� ,�,� ��
Name: rY Regi tratlon #:a Exp.:/ L
Address: ,IT City: -� . State: / Zip Code:
Phone &Type: —d9 ❑Office�]obile Email. r S/
Contact/Rep. Name: Phone: d(% _ Email: t
Mechanical Contractor Authorized Signature: Date: /
3. Project D�gscrigtion
Address:ZS•�'�- c3'� S 0 /� -OR- Lot #: _ Block #: _ Subdivision:
Check one: `Single-family Residence ❑ Multi -family Residence ❑ Commercial
Check one: New Construction* ❑ Remodel ❑ Addition ❑ Basement Finish
Description of work /
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. t r portion thereof)) $
New Multi -Family Residential: ❑ Duplex= $260 Cl 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 O Fireplace/Solid Fuel Burning Unit= $65 ❑ Technical Service= $65/hour
Cl Plan Check =10% of Contracted Amount
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury, I hereby certify that l 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 ofthe
City to enter upon the above-mentioned property for inspections purposes. NOTE: Thebuilding official mayreokea Worn It on approval issued under the provisions of the 2012
International Code in cases of any fake statement or misrepresentation of fact in the application orogtonw c or approval was based. Permitvmdifnot
started within 180 days. Permit void if works stops for 180 days. n �J
Applicant's Name (print): f uIr �/ lQl Signature: Date: / l(P
Inspections must be called in before 8 AM on the day the inspection is requested. Inspecdon 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