HomeMy WebLinkAboutAPPLICATION - 17-00570 - 1513 Red Cedar Rd - Shop Mechanical OnlyO�pPXPUgC
� O
C I TY OF
REXBURG
Amrrkai Family Communi y
Building Safety Department
BUILDING PERMIT FORM 112 City of Rexburg
160,`,W/201 35 North 15C East
BUILDING APPLICATION
Addition SFR Mechanical
Rexburg, Idaho 83440
Cow -,tom
For Office Use
Permit Number: 1*7
�-005 / -7 0 ❑ Mechanical Fee Paid
1. Property p \
Name: 9- 4o�O.�rJ
Address:IS13 R£o OEPA - Qc . City: f�4-7diLA& State: �_.Zip Code: 391
Phone: (1i> %0`j — (o ZS't Email:
Under Idaho Building Code, a homeowner is allowed to do work on the rrownhome.
Are you a homeowner doing work on your own home?
OD, es (Skip to #3 and complete the Homeowner's Exemption)
❑ No, l am working with the homeowner
2. Mechanical Contractor
Business: State License #: Exp.:
Address: City: State: Zip Code:
Phone: Email:
Contact/Rep. Name: Phone: Email:
Mechanical Contractor Authorized Signature: Date:
—
A copy ofyour state registration/license is required to be on file. If this is the first time you have done work in the City of Rexburg, please provide
a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
3. Project Descriptio
Address: 51 , 4 6;-PAA-
Description
;-DAADescription of work: —4Ag Cot-
* New SFR Construction: 1(,96'b sq. ft.
. Feesfor additions are charged by squarefootage: Up to 1,500 sq.ft. = $130 + $65for each additional 1,000 sq.ft. orportion
thereof.
0 Up to 1,500 sq.ft t = $130. Up to 2,500 sq. ft = $195. Up to 3,500 sq. ft. = $230. Up to 4,500 sq - ft t. = $295, etc. (i.e. a home
with 3,675 sq. ft will be charged $295)
❑ Number of Fireplaces:
. Note that fireplaces are not included in square footage costs and will be charged $65 per inspection.
APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, l hereby certify that l have read this application and state that he information
herein is correct and 1 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 irNhe 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): 4 . �,-4WONS Signature: Date:
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