HomeMy WebLinkAboutAPPLICATION MECHANICAL - 17-00435 - 525 S Center St - BYUI - Kimball Ste 130 RemodelCITY OF
I;XBtMG BUILDING PERMIT FORM 210
0- Updaod 1G/201.
Amerirds Family Community
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: RYI I-Itiahn Kimball Finanrp Rllildinn
Address: 525 S Center Street 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: 15138 W Hnmikpr Rd City: Pocatello State: Ir) Zip Code: R39n2
Phone: 208.238.1202 Email: kenyan(a).lcorp.com
Contact/Rep. Name: Ph Email:
Mechanical Contractor Authorized Signature- Date: 8-15-17
A copy ofyour state registration/license is r fired to on fi . his is the first timeyou have done work in the City of Rexburg, please provide
a photo copy ofyour license. /fyou are uns re ify icense is on file, please check with the Permit Technician by calling (208) 372-2341.
3. Project Description
Address: BYU-Idaho Kimball Finance building
Description of work: HVAC Upgrades
❑ Project Cost: $ 37,350. 00
• Feesfor commercial projects are charged by cast
0 First$10,000=245+$60. From $10,000 to$100,000 = 196 + $260. Above $100,000 =.5% +$1,160. i.e. Workcosting
$15,000 will be charged $260 for the first $10,000 and 196 of the remaining $5,000 = $260 + $50 = $310 twee
• There will also be a plan review fee totaling 1096 ofthe above fee.
APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, 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 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. Permitvoidifnot
started within 180 days. Permit void if work stops for 180 days.
Applicant's Name (print): Kenyan Lewis Signatu Date: 8-15-17
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after SAM will be scheduled for the next business day.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341