HomeMy WebLinkAboutAPPLICATION - 19-00130 - 2478 Robison Dr - Country MechanicalRexa1" 0
C 1 TY OF Building Safety Department
V^ REXBIJRG BUILDING PERMIT FORM 410 City of Rexburg
`�w - °Pd`MI 35 North 1St East
America's Family Community
Rexburg, Idaho 83440
BUILDING APPLICATION
Miscellaneous Mechanical Work
FOr 0171'0_4: Use
Permit Number: ---AS -bbl ?)
❑Mechanical Fees Paid
1. Property Owner
Name: Tad Marx
Address: 2478 Robinson City: Rexburg State: Id Zip Code: _ 83440
Phone: 2085308376 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 4 and complete the Homeowner's Exemption)
® No, I am working with the homeowner
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Under Idaho Building Code, a registered contractor must do the work fora Commercial Building.
Business: 24 Heating and Cooling State License #: Hvc-c-6068 Ex 05/2021
Address: 23 N 5th W p.:
City: Rexburg State: Idaho Zip Code: 83440
Phone: 2087162219 Email: 24hourhtg@gmail.com
Contact/Rep. Name: Steve Dick Phone: Email:
Mechanical Contractor Authorized Signature: C_ Date: 3/15/2019
A copy ofyour 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 ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
Project Description
Address: -OR- Lot #: _ Block #: _ Subdivision:
What type of Property: ® Residential ❑ Commercial
Cost of job: $ 2500.
Description of work: Install unit heater in garage and venrt thru roof. Install gas unit heater and switch gas line to high pressure
I
-. 1 ccs: Check all that apply:
® Furnace or A/C = $65 ❑ Fireplace/Solid Fuel Burning Unit:
® Gas Line = $65 o Built-in = $130
❑ Water Heater = $65 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, l hereby certify that I have read this application and state that the information herein
is correct and 1 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): Steve Dick Signature:
Date: 3/15/2019
Inspections 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