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HomeMy WebLinkAboutAPPLICATION - 17-00718 - 1281 Meadowview Ave - FurnaceNov 17 1707:57a Alpine Heating Air 2085520594 p.1 C I TV OF RE"URG ca Anreriml ramify rAmotmily BUILDING APPLICATION Mechanical Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 For Office Ilse Permit Number: Chi I Permit Type: ❑New ❑ Remodei -TAddition ❑Basement Finish Fees Pald: O Yes ©'No 1, Property Q wneFF Name: lu � l-* �.hd yl Address: i :91�Q�I� City: State: Tb Zip Code: Phone &Type;z 9l 1Q'f— r5VOr9 ❑ 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) k1a: I am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property. NOTE: Any mntracto:z/suh-contractors involved will need m submit their own signed applications. 2. Mechal is 1,,Contracto ,1 A ) Name: a i U vto E ri5 Registration #: ] (G/7i G ��$ Exp.: Address: �T/1T��3 d_ # City: State: Zip Code: Phone &Type: ❑ Office ❑ Mobile Email: Contact/Rep. Name: Phone: Email: Mechanical Contractor Authorized Signature: Date: 3. Project Description [ Address: /2 -OR- Lot #:_Block #:_Subdivision: Check one: ❑ Single-family Residence ❑ Multi -family Residence ❑ Commercial Check one: ❑ New Construction* ❑ Remodel ❑ Addition ❑ Basement Finish Description of work: t�a0 New Commercial Work: Co acted amount: Calculated Fee [See Below): $ ❑Upto$10,000= (total costof system x.02)+$60 0 $10,0014100,000=((total cost of system -10,000)x.01)+$260 ❑ Over $100,001 = ((total cost of system -100,000) x.005) + $1,160 Now Sfngi.e-Family Residential Work: Sq. Ft ❑ Up to 1,500 Sq. Ft. _ $130 ❑ 1,501-2,500 Sq. Ft. = $195 ❑ 2,501-3,500 Sq. Ft = $260 ❑ 3,S01 -4,S00 Sq. Ft = $325 ❑ Over 4,500 Sq. Ft.= $325+(65 x # of additional 1,000 Sq. Ft. (or portion thereof)) $ New Multi -Fancily Residential: ❑ Duplex = $260 ❑Three or more units =$((130 x# of buildings)+(65 x # ofunits))$ New work on any other residence and Detached Shops: = S(65 + (10 x # of HVAC fixtures)) Miscellaneous: ❑ Gas Pressure = $6S ❑ Furnace or A/C = $65 ❑ Water Heater = $65 ❑ Requested Inspection= $65 ❑ Gas Line =$65 ❑ 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 appllation and state that the Information herein Is rorrectand I swear that any inform ation which may hereafter be given by me In head rigs 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 rela Ung to the subject matter of this application and hereby authorized representatives of the CtOy to enter upon the above-mendoned property for inspections purposes. NOTE: The but tiling o(Acial may revoke a permit on approval issued under the provisions oftha 2012 I ntcnutionaI Code In cases of any fabe statement or misrepres aeration of fact In the appliatian or on the pta ns on which the permit or approval was based. Permit void if not started valthln 180 days. Permit void ffworkstops for 180 days. �� p `� ,yt�j �7 Applicant's Name (print)• �th- �l!Si7fSignature: ` (lL._.�lA:—`t�tAk�U/115� Date: �/ inspections must be aged In before BAM on the day the inspection is requested. Inspection requests called In afterl! AM will be scheduled for the next business day. Inspection Hatline-[20B]372.2344 www.rexhurg.org PermitTechrdclan-(208)372.2341 Revised March, 2016