HomeMy WebLinkAboutAPPLICATION ELECTRICAL - 16-00307 - 343 Talon Dr - Basement FinishCITY OF
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BUILDING APPLICATION
Electrical
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use
Permit Number: %L' 00301 Permit Type: []New ❑ Remodel ❑ Addition ❑ Basement Finish
Fees Paid: ❑ Yes []No
1. Property Owner
Name: UU NS ON nAir
Address: 3N3 TJOrl Or City:Rte State: %V) ZipCode: t0
Phone & Type: ❑ Office ❑ 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)
❑ No: 1 am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property.
NOTE: Any contracmrs/subcontractors involved will need to submit their own signed applications.
2. Electrical Contractor
Name: C- &G -CL Zkir c rt2tc Registration #: G -t U o i Exp.:
Address: -835 itr7EAw11 '�III City: ZDt4tto Fijlt_s State: 1:n Zip Code: 83uo4
Phone&Type; G21— 6482 _❑Office2g.Mobile Email: G1<arV4 c 41Z CA4OiQ A-±
Contact/Rep. Name: P one: Email:
Electrical Contractor Authorized Signature: ��— Date:7—t9—Il6
3. Project Description
Address: -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. 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 ❑ Requested Inspection= $65
❑ Pumps -Water, Irrigation, Sewage (per motor) = ❑ $65 up to 25HP ❑ $95 26- 200HP ❑ $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 Amount
-[]Temporary Construction Services ONLY= $65 200 amp or less. One location for less than 1 ear.
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 Cityof Rexburg
shall he truthful and correct I agree to coin ply 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 forinspections 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 permit orapproval was based. Permitvoid if not
started within 180 days. Permit void ifwork stops for 180 days.
Applicant's Name (print):
Signature:
Date:
Inspections must he Had in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM will be scheduled for the nextbusines day.
Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March, 2016