HomeMy WebLinkAboutAPPLICATION - 17-00751 - 4832 W 3800 S - New SFR Mech1010xeuto � CITY O P
REXBURG BUILDING PERMIT FORM 110
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AmarkoPanii
Building Safety Department
City of Rexburg
35 North 1St East
VComMurfry Rexburg, Idaho 83440
BUILDING APPLICATION
New SFR Mechanical
For Office Use
Permit Number: 17 - DW E i )"Mechanical Fee Paid
1. Property Owner
Name: SDH Construction
Address: 3966 Rocky Mountain Drive City: Ammon State: ID Zip Code: 83406
Phone: 208-346-0846 Email: I nnaa r npnarrraakhnmeaidahn rnm
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)
10 No, l am working with the homeowner
2. Mechanical Contractor
Business: _Dependable Heating and Air Conditioning State License #: fir' 9'' l 2 4 Exp„05/1/Z/¢
Address: 3851 E 22 N City: Rigby State: ID Zip Code: 83442
Phone: 208-821-7520 Email: dependablehvac06(Ovahoo.com
Contact/Rep. Name: Dennis Hayden Phone: 208-8214520 Email: dependablehvac06(&_vEih00 com
Mechanical Contractor Authorized Signature: __ Dater
A copy ofyour state registration/license is required to be on file. t us is i 7trsrirme you have done work in the City of Rexburg, please provide
a photocopy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
3. Project Description
Address: TBD W 3800 S -OR- Lot #: _ Block #: _ Subdivision:
Description of work: New Construction/ Single Family Home _
Rl SFR Construction: 2190 sq. ft.
• Fees for new construction are charged by square footage: Up to 1,500 sq. ft. = $130 +$65 for each additional 1,000 sq. ft or
portion thereof.
o Up to 1,500 sq. ft = $130. Up to 2,500 sq. ft = $195. Up to 3,500 sq. ft = $260. Up to 4,500 sq. ft = $325, etc. (i.e. a
home with 3,675 sq. Jt will be charged $325)
Q Number of Fireplaces: 1
• Note thatfireplaces are not included in square footage costs and will be charged $65 per inspection.
❑ Hydronic Heating:
• Note that hydronic heating is not included in square footage costs and will be charged and additional $65 + ($10 x # of
manifolds/zones)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that l have read this application and state 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 the City Council for the City of
Rexburg shall be truthful and correct I agree to comply withal] 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 started within 180 days. Permit void if work stops for 180 days.
Applicant's Name (print): CQ Signature: Date:I I /Z
Inspections must be called In before 8 AM on the day t4 Inspeca is requested. Inspection requests caed in after 8 AM will be scheduled for the next business day.