HomeMy WebLinkAboutAPPLICATION - 17-00731 - 1322 N 16th E - Replace HWT, Furnace, Add A/CNov 171703:57p Alpine Heating Air
J4 gr.x11U4p CITY OF
1EXBU1\G Submit By Email
nv
Aonvical, FtniRyCmrmumfg
BUILDING APPLICATION
Mechanical
2085520594 p.1
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For office use
Permit Number: Permit Type: ❑ New ❑ Remodel ❑ Addition ❑ Basement Finish
Fees Paid: ❑ Yes ❑ No
1. Propel 4, Owner,
Name:
l Zip Code:��-N'_
-5,��/ — t --t-' State:
Address: /a-
Phone &Types -t' 5 �Y❑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)
am a contractor working for the homeowner D No: This property Isla Multi -family Residence or Commercial Property.
e01
NOTa; Any toatrnrmn/sub contractors ie volved will need to suhmit ofaar own signed applications.
2. Mechanical Contractor
Name: Alrilne heating&AlrConditioning Registration#:i
HVAC -3258 Exp.:
State: m Zip Code: 83402
Address: 170N. Eastern Ave. City: Idaho Falls
Phone & Type: 10e-523.5542 p Office ❑ Mobile Email: _
! Email:_
208
Contact/Rep. Name:__—Phone:-523-5542
,
Mechanical Contractor Authorized Signature: �— a
Date:___
3. Project D/es�cri Stinn
Address:—' & E -OR- Lot #: _ Block
#: _Subdivision:
-6%
Check one: ❑ Single-family Residence ❑ Multi -family Residence ❑ Commercial
i
Checkone: ❑Newnstr coon* ❑Remodel ❑Addition ❑Baslme
[Finish
Description of work:
New Commercial Work Wintracted amount: $_ Calculated Fee (See Below): $
❑ Up to $10,000 = (total cost of system x,02) + $60 ❑ $10,001-$100,000 = ((total cost of system -10,000) x.01) + $260
❑ Over $100,OD1 = ((total cost of system -100,000) x.005) + $1,160
New Single-PanlllyResidential Work: Sq. Ft L
5q. Ft = $325
❑ Up to 1,500 Sq. Ft. = $130 ❑ 1,501-2,50D Sq, Ft. = $195 ❑ 2,501-3,500 Sq. Ft. = $260 /0 3,501-4,500
❑Over 4,5Q0 Sq. Ft = $325+(65 x # ofadditional 1,000 Sq. Pt. (or portion fhereof)) $
New Multi -Fancily Residential: ❑Duplex = $260❑ Three or more units = $((130 x # of buildtngs)+(65 x # of units))$_
New work on any other residence and Det lched Shops: _ (65 + (10x # of HVAC fixtures)) $
Miscellaneous: ❑ Gas Pressure= $65 ❑ Furnace or A/C = $65 ❑ Water Heater =S65 ❑ Requested Inspection= $65
❑ Gas Line = $65 ❑ Fireplace/Solid Fuel Burning Unit = $65 ❑ Technical Service = $65/hour
i
❑ Plan Check =10%ofContracted Amount 4
APPLICAMrS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that 1 have read this application and state that the Information herein
is comm and 1 swear that any informationwhich may hereafter be given by mein hearings before the Planning and Zoning Commission or the City Coincif for floe City of Rexburg
shall he truthful and correct. 1 agree to comply witb all City regulations and State laws [elating to the sablect matter of this appl(cation and hereby authorised represenur.vm 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 rases of any fa'se statement or misrepresentation of fact in theapphcation oron the plans on which the permit or approval was based. Permit void if not
started within LED days. Permit void Ifwork stops for 180 days.
Applicant's Name(print): ____Signature: I Date:_
Inspections must be called In before SAM on the day the inspection is requested. Inspection requests called in after BAN will be scheduled for the nextbadness day.
Inspecdon Hotline -(208)372.2344 www.rexburgorg Permit Technician -(208)372.2341 Revised March,2016