HomeMy WebLinkAboutAPPLICATION MECHANICAL - 17-00801 - 2300 University Blvd - Madison High School - AdditionInspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM will be scheduled for the next business day. Inspection Hotline – (208) 372.2344 www.rexburg.org Permit Technician – (208) 372.2341
Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440
BUILDING APPLICATION
Miscellaneous Mechanical Work For Office Use Permit Number: ____________________ ⧠ Mechanical Fees Paid 1. Property OwnerName: _______________Madison High School______________________________________Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone: _____________________________________________ 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 section 4 of this application and complete the Homeowner’s Exemption page as well) ⧠ No, I am working with the homeowner 2.Mechanical Contractor
Under Idaho Building Code, a registered contractor must do the work for a Commercial Building.Business: ___________________________________________________________ State License #: _________________________ Exp.: _______________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone: _____________________________________________ Email: _____________________________________________________________ Contact/Rep. Name: ______________________________________ Phone: _____________________ Email: __________________________________________ Mechanical Contractor Authorized Signature: ____________________________________________________________________ Date:________________
A copy of your state registration/license is required to be on file. If this is the first time you have done work in the City of Rexburg, please provide
a photo copy of your license. If you are unsure if your license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project DescriptionAddress: _______________________________________ -OR- Lot #: ____ Block #: ____ Subdivision: _______________________________What type of Property: ⧠ Residential ⧠ CommercialCost of job: $__Description of work: _____________________________________________________________________________________________________________________4. Fees: Check all that apply:⧠ Furnace or A/C = $65⧠ Gas Line = $65⧠ Water Heater = $65 ⧠ Fireplace/Solid Fuel Burning Unit:
o Built-in = $130
o Free-standing = $65⧠ Miscellaneous/Requested Inspection = $65
Inspection fees can be bundled upon request. Re-inspect fees will be enforced if inspection requests exceed fee totals.
APPLICANT’S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I 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 with all 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): ___________________________________ Signature: _____________________________________________ Date: _______________
BUILDING PERMIT FORM Updated 2/2017 410
JM Mechanical, LLC 030308 11/30/20
3775 N 200 W Hyde Park UT 84318435-563-6267 heather.dowd@jmmech.com
Heather Dowd 435-994-0523 heather.dowd@jmmech.com
Heather Dowd 7/3/18
2300 University Blvd
x
496,350.00HVAC for Addition
Heather Dowd 7/3/18Heather Dowd