HomeMy WebLinkAboutAPPLICATION MECHANICAL - 17-00695 - 66 E Main St - Progrexion - RemodelJan 0518 01:51 p
Alpine Heating Air
CITY OF
REXBURG
Aoredcn's Family Community
Submit By Email
BUILDING APPLICATION
Mechanical
2085520594
5
P.1
Building Safety Department
City of Rexburg
35 North 15t East
Rexburg, Idaho 83440
For Office Use
Permit Number: __ _ Permit Type: []New ❑ Remodel ❑ Addition ❑ Basement Finish
Fees Paid: ❑ Yes ❑ No
1.Prnner�y�ver
NaAddress: City: ,9� State: z� Zip Code:
Phone & Type: D 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)
❑ No:1 am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property.
NOTE: Any mn[rac[nrs(sub-con[rncws Involved will needwsulinn It their own signed applications.
2. Mechanical Contractor
Name: AI Ineheating&Air Conditioning _Registration #: HVAC -3258 Exp.: _
Address: 170 N. Eastern Ave. _ City: Idaho Fails
-State: 10 Zip Code: 83402
Phone &Type; 2011 ftl Office ❑ Mobile Email:---
Contact/Rep.
mail:__Contact/Rep. Name: Phone: Zoe -523-5542 Email:
Mechanical Contractor Authorized Signature: Date:
3. Project Description
Address: IP -6 E a o _ -OR- Lot III: _ Block #;_ Subdivision:
_
Check one: ❑ Single-family Residence ❑ Multi -family Residence Commercial
Check one: ❑ New Const�ru�ction" -rRemodel ❑ Addition ❑ Basement Finish
Description afwork:�V �-
New 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 of 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 # ofadditional 1,000 Sq. Ft (or portion thereof)) $--
New Muld-l'.irnily Residential: 0 Duplex= $260
_NewMuld-i'anlilyResidential:❑Duplex=$260❑ Three ormore units= $((130x#ofbuildings)+(65x#of units))$_
New work un 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= 365/hour
❑ Plan Check =10% of Contracted Amount
APPLICANT'S SIGNATURE, CERTIPICATION AND AUTHORIZATION: Under penalty of perjury, l hereby certify that 1 have mad this application and state that the information herein
is. rectand I swear that any Information which may hereaRerbe given by mein hearings before the Planning and Zoning Cum mission or the City Council for the City of Rexburg
shall he truthM and tarred. I agree to comply withal[ City regulations and State laws Waring to the sub)ect matter of this appli cation and hereby authorized mpreseotadves of the
City to enter upon the abova-mentioned property for his pecdons purposes. NOTC: The building oFicial may revoke a permit on approval Issued under the provisions of the 2012
Inman MthilCodeinmasesrmit vfakesmrk smpsfmISOd eseraatlon offact Inthe applindenoronthe plans onwhich the permit orapproval was based. Perritt voi t
started within 100 days. Permit void ifurork Sups for [BOdays. '
Applicant's Name (print . "Aig 2t'h.Jgnawre: Q.�.>,.i✓� _ / S
Inspectionsmust be railed in before 8 AM on the day the inspection is rectum ted. Inspection requests called In after SAM will he scheduled for the next buslncss day.
reps cdon Ilotlina-(200)372.2344 1 wvvw.rexburg.otg Permit Technician -(208)372.2341 Revised March, 2016