HomeMy WebLinkAboutAPPLICATION ELECTRICAL - 16-00683-684 - Sugar Mill ApartmentsC I TY OF
REXBURG
Amcriwa Family community
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BUILDING APPLICATION
Electrical
Building Safety Deparhnent
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use
Permit Number: Permit Type: ❑ New ❑ Remodel ❑ Addition ❑ Basement Finish
Fees Paid: ❑ Yes ❑ No
1. Property Owner
Name: St peck �s AIPA /_f -C
Address: P7 C) .two < 14 a City: /WdA kti State: T All Zip Cade: 'RSL -0>4
Phone &Type:aOS-NSo-34x4 ❑ Office jffMobile Email: I
e nrl<o�-nl��nzaLCG.co.-
Under Idaho Building Code, a homeowner is allowed to do work on th€ir own home.
Are you a homeowner doing work on your own home? ❑ Yes (Skip to #3 and complete the Homeowner's Exemption page)
❑ No: l 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:_/Ue'1s6,. Registration#: SI - Exp.: Iiia. as
Address: _P. G , '9ti 14.1. City: /Xe n 4- State: 'a'- Zip Code: �!
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Phone &Type:Q63? S` O 3L1 �`l ❑ Office�Mobile Email2
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Contact/Rep. Name: Phone: Email:
Electrical Contractor Authorized Signature; Date: /G --1 - 00 11.
3.ProjectDegCep op I��r 4'0 ��
Address: 'L WI -OR- Lot #: _ Block #: _ Subdivision:
Check one: ❑ Single-family Residence ❑ Multi -family Residence ❑ Commercial R- 2 pOLf i PrH �i
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 Amoun
Temporary Construction Services ONLY = $65 200 aom or less. One location for less than 1 ear.
APPLICANT'S SIGNATURE, CERTIFICATION ANDAUTHORIZATION: Underpenalty ofperjury, I hereby certify that l have read this application and state thatthe information herein
Is correct and 1 swearthat anyinformationwhich mayhereafterbe given by mein hearings before the Plan ringand Zoning Commission orthe City Council for the Cityof Rexburg
shall be truthful and correct I agree to comply with all Chyregulations and State laws relatingto the so r of this applicatio and hereby authorized representatives of the
Cityto enter upon the above-mentioned property for inspections purposes. NOTE: The buildi cial ma okeapermitona valissued undertheprovisions of the 2012
International Code in cases ofanyfalsesmtement or misrepresentation of fact in the appli on or on the, ns onwhice t rapprovalwas based. Pennitvoid'fnot
started within 180 days. Permit void if work stops for180aa��ys.
Applicant's Name (print):/kR[K ? W+�rTso!-( Signatu Date: O l
Inspections must be abed in before 8 AM on the daythe inspection is requesto$111ospection requests called inafter 8 A will be scheduled forthe nextbusiness day.
Inspection Hotline -(208)372.2344 wwmrexburg.org Permit Technician -(208)372.2341 Revised March, 2016