HomeMy WebLinkAboutAPPLICATION - 17-00437 - Calvary Chapel - AC Install 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
Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440
BUILDING APPLICATION Mechanical For Office Use Permit Number: ____________________ Permit Type: ⧠ New ⧠ Remodel ⧠ Addition ⧠ Basement Finish Fees Paid: ⧠ Yes ⧠ No 1. Property Owner Name: ___________________________________________________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ 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: 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: _____________________________________________________________ Registration #: _________________________ Exp.: _______________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: ___________________________________ ⧠ Office ⧠ Mobile Email: __________________________________________________________ Contact/Rep . Name: ______________________________________ Phone: _____________________ Email: __________________________________________ Mechanical Contractor Authorized Signature: ____________________________________________________________________ Date:________________ 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 ⧠ $10,001-$100,000 = ((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: 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 me in 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 permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Applicant’s Name (print): ___________________________________ Signature: _____________________________________________ Date: _______________
Calvary Chapel Rexburg
104 College St Rexburg ID 83440
/ Mark Paulsen
208.346.0999
A Pro Appliance LLC 000737 12/31/17
467 Constitution Way Idaho Falls Idaho 83402
208.206.1908 aproappliance@rocketmail.com
Shontel Sperl 208.206.1908 aproappliance@rocketmail.com
07/28/17
104 College St
Install A/C throughout building with condensor unit
Shontel Sperl 07/28/17