HomeMy WebLinkAboutAPPLICAITON ELECTRICAL - 17-00727 - 178 Sequoia Ave - GeneratoroQRexo°,p�.
CITY OF
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BUILDING APPLICATION
Electrical
Building Safety Department
City of Rexburg
35 North 151 East
Rexburg, Idaho 83440
For Office lJse...
PermitNmfiber:, Permit Type: 13 New .-❑Remodel ❑Addition 11BasemenbFinish'
Eees Paid: O Yes El
1. Property Owner
Name: `1 c41 c L CL P/r:.S�{C� i )
Address: /74: �i F. �i W i'a< 6 rCity; B 1 tiX��[t l State: / U Zip Code: y l it r
Phone & Type �ff�V56 3`P 0 Office O 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? D Yes (Skip to #3 and complete the Homeowner's Exemption page)
0 No: I am a contractor working for the homeowner 0 No: This property is a Multi -family Residence or Commercial Property.
NOTE:Any contractors/sub-contactors Involved will need to submit theirown signed applications.
2. Electrical Contractor _ /
Name: �jis ak I Sea'•'-� art c, Reggistration#:G "Exp.:
Address: 1,14(t fid Ch__ l —City: lci hG 1 -al IS r Sta� Zip Code: SS3't f'
Phone & Type, -J26L- 6�- 7 77 ® Office 0Mobile Email- C.°✓tt'{.i✓Si-6411)t+ et/t,er'"
Contact/Rep. Name: 'S ii`A%t U_/6 d ti Phone:.+//'S �J)-i l I'FinaiL•cel' r.=L �-1, G,` —
Eli ectrlcal`ContractorAuthor&dSignature'' ,':'I' t -s Date a I�
3. Project liscriptjon
Address: ?K -`_•t= Si4 I! u- A V' e . -OR- Lot #: _ Block #: _ Subdivision:
Check one lSin e -family Residence 0 Multi -family Residence 0 Commercial
Check one: 0 New Constructiop* 0 Remodel D Addition 0 Basement Finish
Description of work:X-2 � l
New Commercial Work: Contracted amount: $ Calculated Fee (See Below): $
O Up to $10,000 = (total cost of system X,02).+ $60 0 $101001-$100,000 = ((total cost of system -10,000) x.01) + $260
O Over $100,001= ((total cost of system -100,000) x.005) + $1,160
New Single -Family Residential Work: Sq. Ft
0 Up to 1,500 Sq. Ft = $130 0 1,501-2,500 Sq. Ft = $195 0 2,501-3,500 Sq. Ft = $260 0 3,501-4,500 Sq. Ft = $325
0 Over 4,500 Sq. Ft = $325+(65 x # of additional 1,000 Sq. Ft (or portion thereof)) $
New Multi -Family Residential: ❑ Duplex =$260 0 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 branch circuits)) $
Miscellaneous: 0 Small Works{work costing less than $200 with no change in service connections)=$10(needs no inspection.
Central Heating/Cooling Systems = $65 0 Spas, Hot Tubs, and Swimming Pools= $6$ 0 Requested Inspection .= $65
0 Pumps -Water, Irrigation, Sewage (per motor) = 0 $65 up to 25HP 0 $95 26- 200HP 0 $130 over200HP
f1 Irrigation Machine = $65 for center pivot+$10 per tower of drive motor $ ❑ Technical Service =$65/hour
0 TemporaryAmusement= $65 +$i0 per ride, concession, or generator $ 0 Plan Check=10%, of Contracted Amoun
1.0 Tem ora ` Construction Services ONLY =$65 200 amp or less. One location for less than 1 year.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Underpenalty, ofperjury, I hereby certify that I have read this application andstate that the Information herein
is correct and 1 swearthatany Information which may hereafterbe given by mein hearings before the Planningand Zoning Commission orthe City Council forthe Cityof Rexburg
shall be truthful and correct I agree to comply with all City regulations and State lava 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 ofthe 2012
International Code in cases ofanyfalse statement or misrepresentation offact in the application oron the plans on which the permit orapprowd was based. Permitvoidifnot
started within 180 days. Permit void ifworkstops for 180 days.
Applicant's Name (print): Signature: Date
Inspections mustbe ailed in before a AM on the day the inspection is requested. Inspection requests called inaftere AM will be scheduled forthe next business day.
Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March. 2016