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Home My WebLink AboutAPPLICATION ELECTRICAL - 18-00558 - 1376 Stone Dr - New SFRC t TY ° p _ Building Safety Department JIMURG BUILDING PERMIT FORM 120 City of Rexburg C%b, - — i'Pa e31.m, AmerfcasFamily Community 35 North 1st East Rexburg, Idaho 83440 SFR ELECTRICAL BUILDING APPLICATiory O New Construction 0 Addition For Office lyse Permit Number. :jLb - if•nuSSg it Basement Finish ❑ Accessory Structure > 200 sq, ft. 11Elect: Electrical Pee Pain 7. Property Owner Name: �r/SL__ i` a. s SPI LSLY :� 4` LL. G. Address: �A C- _ r Phone: t a �._._ —City: _ _State: ` �( b - 7 t t�tL.' _ 1 Zip Code: _ Under Idaho Building Code, a homeowner is allowed to do work on their own home, v Are you a homeowner doing work on your own home? ❑ Yes (Skip to 43 and complete the homeowner's Exemption) Ido, I am working with the homeowner 2. Electrics Contra( Business: Address: Phone: Zf% . l Contact/Rep. Name, Electrical Contractor Authorized Signature: A copy ofyour state registration/license is requir, a photo copy ofyour license. lfyou are unsure if�i Stat License #: _ Oat% Exp.: U City- WVI� hl St St te: Zip Code: 2�d . �_ - . Dat 25'--% eon file. If this is the first timeyou have done work in the City of Rexburg, please provide license is on fill; please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address: -OR- Lot #. Block #: 7- _ Subdivision: Description of work: New SFR Construction: sq. ft. A?es for additions are charged bysquare footage: up to 1,500sq. f. = X130 thereof. +$bS foreach additiona11,000sq. jt or portion Square Footage Total cost -6-t-0-T, 5 -5 -0 -s -q-, fL 1 $130 1,500 to 2,500 sq, ft $295 2,500 to 3,500 sq. fG .$260 3,500 to 4500 sq. fc $325 L Add $65 per additional thousand sq. ft C3 Spas/Pools/Generators: ❑ Yes El No • ,Vote that spas/pools/generators are not included in square footage costs and will be charged S65 per inspection. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty nfperj-.iry. I hereby certify that I have read tits application and state that rhe information herein is correct and t swear that any Information which may hereafter be given by mem hearings before she Planning and Zoning Commission or the City Council for lase City of Rexburg shall be truthful and correct. 1 agree to comply with all City remilat!.ans and State laws relat:rg to the subject matter of this application and hereby author fixed representatives u Rexburg City to enter upon the above-mentioned property for inspection., purposes. NOTE: The bui:ding official may revoke a permit on approval issued under the p ruvisions of the 2012 the International Code in cases of any false statement or misrepresentation of fact in the application at 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: inspections must he called in before 8 AM en the day the inspection is reque aspect;on rect ests called in after 8 ASI will be scheduled for the next business day. Inspection HoU�oe-("L081372.234a w xxv.i exbuirLorg Permit Technician - (208) 372.2341 oti Atxeuec a� CITY OF Building Safety Department ° URG BUILDING PERMIT FORM 4 City of Rexburg A 35 North 1st East merica's Fatuity Community " tG Rexburg, Idaho 83440 BUILDING APPLICATION Miscellaneous Electrical Work For Office use Permit Number: _� • 0()S68 - 18 - o65S 1 ❑ Electrical Fees Paid 1. Property Qwner Name:'1.f.t < Address:' '' t S�' Q - yz -x�G�" City: StaterZip Code: Phone: L2 -o � Z o , Email: _ 4-sv,ti r, lar a 8y -{- f tr. r, Ce IC "I' 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 44 and complete the Homeowner's Exemption) I am working with the homeowner 2. Electrical Contractor Under Idaho Building Code, a registered contractor must do the work for a commercial Building. Business: State License#: ff Address: Phone: , Ems" p' City:.. State: Zip Code: ma Contact/Rep. Name: �. Phone: Email: Electrical Contractor Authorized Signature: Date: ?—I?-_fr A copy ofyour state registration/license is required eon file. if this is the first time you have done work in the City of Rexburg, please pro% a photo copy ofyour license. Ifyou are unsure ify ur license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address: -13'7D *I' k"730 ,. 041, -OR- Lot #: -_-- Block #: —Subdivision: What type of Property: O Residential ❑ Commercial - Cost of job: $ .� Description of work: 4. Fees: Check all that apply: ❑ Central Heating/Cooling Systems = $65 Temporary Electrical Services ONLY = $65 (200 amp or less. One location, for less than 1 year.) ❑ New Circuits = $(65 + ($10 x # of branch circuits)) ❑ Miscellaneous/Requested inspection = $65 ❑ Generators = $65 ❑ Irrigation Machine = $65 for center pivot + S10 per tower or drive motor = $—__ APPLICANrs SIGNATURE. CF.RTI FI('ATlnte A Nn n Pumps - Water, Irrigation, Sewage (per motor) o $65 - up to 25HP o $95 - 26- 200HP o $130 - over 200HP ❑ Spas, Hot Tubs, and Swimming Pools = $65 O Temporary Amusement = $65 + $10 per ride, concession, or generator $__ , . __ Inspection fees can be bundled upon request= Re -inspect fees will be enforced ifinspection requests exceed fee totals. - r -•i" r • • —>ur Uwa I odVe redo tats appitcanon and state that the information herein is correct and i sweat that any information which may hereafter be given by mein hearings before tde Planning and 7.oning Commission or the city Council far the City of Rexburg shall be truthful and correct. t 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 rhe above.-mentoned property for inspections purpuses. NOTE. The buiid_ng official may revoke a permit on approval issued under the provisions of the 2012 International Code in, ases of any false statement or misrepresentation of iact in the application or on the plans on which the permit or approval was based. Permit timid if not started within 180 da}m. Permit void if work stops for- 180 days. Applicant's [Mame (print). Signature:.. )ate: lnspecdons must be called 1n before SAM on the day the inspection is requested. Inspection requests called In atter SAM will be scheduled for the next business day. Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341