HomeMy WebLinkAboutAPPLICATION - 18-00676 - 2851 W 2600 S - New SFR County - fireplaceCITY OF
1 EXB lJ G Submit By Email
ti
America} Family Community
BUILDING APPLICATION
Mechanical
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use
Permit Number: Permit Type: ❑ New ❑ Remodel ❑ Addition ❑ Basement Finish
Fees Paid: ❑ Yes ❑ No
1. Properly Owner
Name: `'1)\\AN �4r��Y1 p�22``\\
Address: Zoo(\C) �\ �/City: e%��J State :l�-Zip Code:
��
Phone & Type:30UY- �-la ❑ Office 6Mobile 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)
9(,No: l am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property.
NOTE. Any contra eters/subcontractors involved will need m suhmit their own signed applications.
2. Mechanical C.ontract, Contractor t� \ p` �O a
Name: \%\e
t C �C?�t rh �l . gistration #: 4�p-
� ' � \1� Exp.:
O\
\2,� \Ar\\�2.v'S\h1 Cf Z Code:
Phone &Type: —�\—SOOffice-�Mobile Email: Contact/Rep. Name• RI C. art \ S ne ail: �aM�
Mechanical Contractor Authorized Signature: Date:
3. ProjectDesc�riQtion �eYXJ�rGt
Address: ZLO 69 �, w OR- boll #: _ Block #: _ Subdivision:
Check one: ❑ Single-family Residence ❑ Multi -family Residence ❑ Commercial
Check one: *ew Construction* ❑ Remodel ❑ Addition ❑ Basement Finish
Description of work:
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 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 thereo(j) $
New Multi -Family Residential: ❑ Duplex= $260 ❑ Three or more units = $((130 x # of buildings)+(65 x # of units))$_
New work on any other residence and Detached Shops: _ (65 + (10 x # of HVAC fixtures))
Miscellaneous: ❑ Cas Pressure = $65 ❑ Furnace or A/C = $65 ❑ Water Heater = $65 ❑ Requested Inspection= $65
❑ Gas Line = $65 Fireplace/Solid Fuel Burning Unit= $65 ❑ Technical Servicez: $65/hour
❑ Plan Check =10% of Contracted Amount
APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, l hereby certify that 1 have read this application and state that the information herein
is correct and I swear that any information which may hereafter be given by mein hearings before the Planning and Zoning Commission or the City Council for the Cityof 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-mendoned property for inspections purposes. NOTE: The building official me vokea tonapproval'ssuedundereheprovisions ofthe2012
International Code in cases ofany false statement or misrepresentation of fact in the application or on nsonwhic epermitorappmvalwasbased. Permitvoidifnot
started within 180 days. Permit void ifwork stops for 180 days,
Applicant's Name (print):1Z(ClL- WAVri S
Date: Z/ -3v- 8
Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests called in after AM will be scheduled for the next business day.
Inspection Hotline -(208)372.2344 www.rexburg.org Perm it Technician -(208)372.2341 Revised March, 2016