HomeMy WebLinkAboutAPPLICATION - 17-00758 - 877 E 7800 S - FurnaceDec 08 1708:08a Alpine Heating Air 2085520594 p.1
C I TY O F
REX.BURG
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Amrrlru's Mmily Cennnunhy
Submit By Email
BUILDING APPLICATION
Mechanical
Building Safety Department
City of Rexburg
35 North ist East
Rexburg, Idaho 83440
For Office Use /7`� 7Jrb.
Permit Number:_ _ Permit Type: ❑New ❑Remodel ❑Addition ❑ Basement Finish
Fees Paid: []Yes ❑No
1. Property Owner Q
Name: 124 Aln�2 �t,,{1,,,a,
Address:. s City: A t� State: � Zip Code; Y-
Phone&Typo:z__.z ^313-$203 ❑OfficeWMobile Email:
Under Idaho Building Code, a homeowner is allowed to do work on their own home.
Are ou a homeowner doing work on your own home? O Yes (Skip to #3 and complete the Homeowner's Exemption page]
No: l am a contractor working for the homeowner ❑ No; This property is a Multi -family Residence or Commercial Property.
N OIL': Any eoneractors: sub-contrarrors involved will need m submit [heir uvm signed upplicalimis.
2. Mechanical Contractor
Name: amine heating& Air Conditioning Registration#: F1VAC-3258 Exp.: _
Address: 170 N. Eastern Ave. City; Idaho Falls State: to Zip Code: s3402
Phone & Type: 20e-523-5542 _ p Office ❑ Mobile Email:__ _
Contact/Rep. Name: _ Phone:?oa-523-5542 Email:
tlechanical Contractor Authorized Signature: Date:
3. Project Description
Address: -OR- Lot #; _ Block #: _ Subdivision: _
Check one: ❑Single-family Residence Multi -family Residence ❑ Commercial
Check one: ❑New Co structlon' Rem del ❑Addition ❑B sementFinis
Description of work: Ht.V.. �e '0 -
New Commercial Work: Contracted 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 $100,001= ((total cost of system -100,000) x.005) + $1,160
New Single -Family Rcsiden tial Work. - Sq. Ft
❑ Up to 1,500 5q. Ft. = $130 ❑ 1,501-2,500 Sq. Ft ee$195 ❑ 2,501-3,500 Sq. Ft. = $260 ❑ 3,501-4,500 Sq. FC = $325
0 Over 4,500 Sq. Ft = $325+(65 x # ofadditional 1,000 Sq. Ft. (or portion thereof)) $
New Multi -Family Residential: 0 Duplex= $260 ❑ Three or more units= $((130 x # of buildings)+(65 x # of un[ts])$_
New work un any other residence and Detached Shops: = S(65 + (10 x # of HVAC fixtures))
Miscellaneous: ❑ Gas Pressure= $65 ❑ Furnace or A/C = $65 ❑ Water Heater = $65 ❑ Requested Inspection = $65
❑ Gas Line ee $65 ❑ Fireplace/Solid Fuel Burning Unit= $65 []Technical Services; $65/hour
❑ Plan Check =10% of Contracted Amount
APPLICANT'S SIGNATURE,CERTTPICATION AND AUTHORIZATION: Under penalty orperlury, l hereby certify, that l have read We application and stale that the information herein
Is correct and I swear that anylnfornationwhich may hereafter be givenby mein hearings before the Planning and Zoning Commission orthe City Council for the CityoFRexburg
sha0 he rmthful and cartes. (agree to comply with all City regulations and State laws relad ng to the subject matter of this application and hershysuthorized representatives of the
City to emerupon the above-mentioned property for Inspections purposes. NOTE: The building ofP.elal may revoke a permit on approval Issued under the provisions of the 2012
international Code Incases ofany rake statement or misrepresentation offattin the application or on the plans on which the permit or approval was based. PermltvoidUnot
started within IBD days. Panu t void if work stops far180 days. ((
Applicant's Name (print):'[ e. AVIA- fes-Sure
ignat: � � q& �p�ate;/;,7/547
Inspections mustbe called In before BAN) an the day the inspection is requested. Inspection requests called in after 8 AAI will be scheduled For the next business day. *"
Inspecdonfludinc-(2081372.2344 wvrx.rexburgorg Permit Technician -(208)372.2341 Revised March, 2016
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