HomeMy WebLinkAboutAPPLICATION - 17-00757 - 649 S 2nd W - The Ivy - Ductless InstallDec 06 17 02:34p Alpine Heating Air 2085520594 p.1
CITY OF
REXBURG
Anrrrkp3 Fannie Comisfundy
Submit By Email
BUILDING APPLICATION
Mechanical
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
Fm• Office Use
Permit Number: —T � _ Permit Type: ❑New ❑Remodel ❑Addition ❑Basement Finish
Fees Paid: kes ❑ No
1. Prop arty Owner
Name:
Address:_ City:_aea State:_T__b_ZipCode: Off_
Phone &T .556— &_5 5C� ❑ 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)
IXNo: I am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property.
N01'E: Any cmuroctors/sub mntrocturs involved will need in snbntl[ then omr slgneE applicators.
2. Mechanical Contractor
Name: Airline heating& Air Conditioning Registration 4: HVAC -3258 EXP.:
Address: 170 N. Eastern Ave. City: Idaho Falls State: ID Zip Code: 83302 __
Phone&Type:208-523.5542 pOffice❑Mobile Email:
Contact/Rep. Name: Phone:?D8_sZMSIZ Email:__
Mechanical Contractor Authorized Signature: Date:__
3. Project Descrl rtion
Address: � dad JJ__ -OR- Lot It: _ Block #: _ Subdivision: _
Check one: ❑ Single-family Residence 'OMulti-family Residence ❑ Commercial
Check one: ❑ New Constructlon" ❑ Remodel Addition ❑ Basement Finish
Description of work:
Now Commercial Work: Contracted amount: $ Calculated Fee (See Below): $
❑ Up to $10,000 = (total cost of system x.02) + $60 ❑ $10,0014100,000 = ((total cost of system -10,000) x.01) + $260
❑ Over $100,001 = ((total cost Df system -100,000) x.005) + $1,160
New Single -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 ❑ 3,501-4,500 Sq. Ft = $325
❑ Over 4,500 Sq. Ft. _ $325+(65 x # of additional 1,000 Sq. Ft. (or portion thereof)) $
New Multi -Family Residentlal: ❑ Duplex= $260 ❑ Three or more unitst: $((130 x# of buildings)+(65 x# of units))$_
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 = $65 ❑ Requested Inspection= $65
❑ Gas Line = $65 ❑ Fireplace/Solid Fuel Burning Unit = $65 []Technical Service = $6S/hour
❑ Plan Check =10% of Contracted Amount
APPLICANT'S SIONA'I'BRE. CERTIFICATION AND AUTHORIZATION: Under penalty orperjury, Ihereby certify that l have read this application and state that the information herein
Is currectand 1 swear that any Information which mayherealurbe giwnby mein hearings before the Planning and Zoning Commission or me City Council scribe Cltyof ilexhurg
shall be truthful and eorrect. I agree to comply with all City regulations and State laws relating to the subject matterof this application and hereby authorized rconezentativcs of thu
City toe ner upon the above-muntoned property forinspectins purposes. NDTE: The building official may revoke a permit on approval Issued under the provisions of the 2012
International Code In uses ofany falsestatemerg or misrepresentation orfaat In the application or on the plans on which the permit or approval was based. Permit void ifnot
started within 180 days. Perneit miidd�ifw�nrk stops for 180 days. r
Applicant's Name (print)A
: 't t. J P,h[4$%natur�ate:
inspo c tions rent beearl d Io b [,, re B AM on the day the Inspealon is requested. Inspection requests etied in after 8 AM will be se hedoled For the at buss ress day.
Inspector Hotline -(208)372.2344 wwwrexbureorg Permit Technicia o-(208)372.2341 Revise d March, 2016