HomeMy WebLinkAboutAPPLICATION MECHANICAL - 17-00312 - 525 S Center St - BYUI - Hart Building - RemodelCITY OF
REXBURG
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Amsrim's Family Community
BUILDING PERMIT FORM 21
U daudto/2016
BUILDING APPLICATION
Commercial Mechanical
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use
Permit Number: Mechanical Fees Paid
1. Property Owner
Name:_ BYU-1 Hart Building - Remodel
Address: 525 S Center Strppt City: Rexburg State: Idaho Zip Code: 83440
Phone: Email:
2. Mechanical Contractor
Under Idaho Building Code, a registered contractor must do the work for a Commercial Building.
Business: Lewis Corporation State License #: HVC-C-4440 Exp.: 5-31-19
Address: 15136 W Hiln7ikar Rd City: Pocatello State: ld;;hn Zip Code: 83202
Phone: _2(16 938 1907 Email: kenyanalcorp com
Contact/Rep. Name: Kenyan Lewise: 2 Email:
Mechanical Contractor AuthorizedSignatu Date: 7 31-17
A copy ofyour state registration/license is req red to on file. If this is the first time you have done work in the City of Rexburg, please provide
n photo copy ofyour license. Ifyou are unsure' rlicense is onfile, please check with the Permit Technician by calling(208)372-2341.
3. Project Description
Address: BYU-I Hart Building
Description of work: HVAC Upgrades
❑ Project Cost: $
• Fees for commercial projects are charged by cost:
0 First $10,000 = 2% + $60. From $10,000 to $100,000 = I % + $260. Above $100,000 =.5% +$1,160. i.e. Work costing
$15,000 will be charged $260 for the first $10,000 and 196 of the remaining $5,000 = $260 + $50 = $310 total
• There will also be a plan review fee totaling 1040 of the above fee.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that l have read this application and state that the information herein
is correctand 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 withal] 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.
4�Applicant's Name (print): Kenyan Lewis Signat Date: 7-31-17
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after B AM will be scheduled for the next business day.
Inspection Hotline - (208) 372.2344 www.rexburg.arg Permit Technician - (208) 372.2341