HomeMy WebLinkAboutAPPLICATION - 17-00591 - 360 Partridge Ln - FireplaceSep .19.a 011 4:16PM0F LEISURE TIME BuildN0o9138,ty1P,-91.3
REXBURG City of Rexburg
nv 35 North 1n East
Amervraf Family Cammunr'ty Rexburg, Idaho 83440
BUILDING APPLICATION
Mechanical
For Office Use
Permit Number: Permit Type: ❑ New ❑ Remodel []Addition ❑ Basement Finish
Fees Paid: ❑ Yes O No
1. Property Owner
Name: 13605 CRIJNING
Address: t City: IU State: -ti- P Zip Code:83` 0
Phone & Type: 0 - 040 ❑Office,6Mobile 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:_ ` \)II1P 00 E2
�� P „_, Registration #: Exp.:
Address; 0 N. W001712 UFF City• D Wt1 HO F Star Zip Code: 0
Phone & Type: - (o I:Office O Mobile Email:
Contact/Rep. Name: O214WN V& Sl -1 E46 -NI E Phone: Emall: 5UPH L06yltC rf wler fvc• Cv44
MechanicalContractbrAuthorizedSignature: Date: /
3. Protect Description
Address: -OR- Lot #:,_ Block #: Subdivision:
Check one:❑ Single-family Residence❑ Multi -family Residence n Commercial
Check one:❑New Construction*❑Remodel ❑Addition OBasement Finish
Description of work:
New Commercial Work:Contracted amount. $ Calculated Fee (See Below): $
OUp to $10,000 = (total cost of system X.02) + $60 0$10,001-$100,000 ie ((total cost of system -10,000) x.0 1) + $260
❑Over $100,001= ((total cost of system -100,000) x .005) + $1,160
New Single -Family Residential Work: q. Ft
❑ Up to 1,500 Sq. Ft = $130 ❑ 1,501-2,500 Sq. Ft. = $195 ❑ 2,501-3,500 Sq. Ft = $260 D 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 Muld-Family Residenrial:❑ Duplex= $260 O 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 D Furnace orA/C = $650 Water Heateras $650 Requested Inspection= $65
❑ Gas Line = $65 Aireplace/Solid Fuel Burning Unit= $65 ❑ Technical Service =$6S/hour
O Plan Check =10% of Contracted Amount
APPLICANT '5510NATURE, CERTIFICATION AND AUTHOR12ATION: Under penalty ofperjury, I hereby certify that l have read this application and sure 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 rhe City Council for the City Of Rexburg
shall be truthful and correct (agree to comply withal) City regulations and state laws relating to the subject matter of this application and hereby authorized representatives Ofthe
City to enrer upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under [he provisions ofthe 2012
MurneuonalCode In cases ofany false soremenrormisrepretebtadon offactin theepplication oron the plans no which the permitorappreval was based. Permitwidifnec
smrted wlthl0 190 days, Permit Bold If Work stops far 180 day.
Applicants Name (print): j V 11 F 000 l; f? Signature:— r Date:
H VC -SC -6S
Inspections must be called in before 8 AM on the day die Inspection Is requested. InspeCt0h tequeset called in after SAM will be scheduled for the next business day,
Inspection Hodine-[208]372.2344 www.rexburg.org PermirTechnicion-(208)372.2341 Revised March, 2016