HomeMy WebLinkAboutAPPLICATION MECHANICAL - 17-00651 - 3750 Redwood Ct - New SFR Mechanical.� c1Tx or Building Safety Department
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City of Rexburg
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35 North 1St East
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An<erla4Family C'ommuniiy Rexburg, Idaho 83440
BUILDING APPLICATION
Mechanical
For Office Use
Permit Number: Perlttit Type: ❑New El Remodel❑ Addition 171Basement Finish
Fees Paid: ❑ Yes ❑ Na
1. PropertV Owner
Name: ThR ti„
Address: SO City. State: Zip Cade:
Phone &Type• DB- �Mo-�503 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/sul>-contractors involved will need to submit their own signed applications.
2. Mecha pica., Contractor N `� "`
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Name: z Registr tion #: j� 8 Exp.:
Address: Ci State:
tY _ _L_� Zip Code:,.
Phone & Type,ZDS-SZ , -Ss S4 :2_ _ Office ❑ Mobile Email: V
Contact/Rep. Name: Phone: Email:
Mechanical Contractor Authorized Signature: Date:
3, Project Description p
Address: �3q 50 (�},r -Ori- Lot #: —Block It: _ Subdivision:
Check one: Single-family Residence El Multi -family Residence ❑ Commercial
Check one: New Construction* ❑ Remodel ❑ Addition Basement Finish
Description of work:
New Commercial Work: Contracted amount: $ CalcuIated Fee (See Below): $
❑ Up to $10,000 = (total cost of system x.02) + $60 ❑ $10,001-$100,000 = ((totaI cost of system -10,000) x.01) + $260
❑ Over $100,001 = ((total cost of system -100,000) x.005) + $1,160
New Single -Fara ly Residential Work: Sq, Ft.
❑ Up to 1,500 Sq. Ft. = $130 )(1,501-2,500 Sq. F - $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 1,0 q Ft. (or portion thereof)) $
New Multi -Family Residential: ❑ Duplex = $260 []Three or more units= $C(130 x # of buildings) +(65 x # of units))$
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 = $6S ❑ Requested Inspection = $65
❑ Gas Line = $65 El 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 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, Permit void if not
darted within 180 days, Permit vo' rkstops for 180 days.
Applicant's Name (print): _� .._—Date:�gnurer' A /
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 Techniclan - (208) 372.2341 Revised March, 2016