HomeMy WebLinkAboutAPPLICATION MECHANICAL - 19-00043 - 575 W 7th S - Madison Middle School - Remodeln pEXHUq�
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BUILDING APPLICATION
New Commercial Mechanical
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use 19-00043
Calculation for inspection fee:
Permit Number:
Mechanical Fees Paid ❑
L Property Owner
((Cost0fproject-$10,000)'1%)+$260
Name: Madison School Dist #321
((Costofproject-$100,000)•54%)+$1160
Address: 60 W Main Street
City: Rexburg State: Idaho Zip Code: 83440
Phone: 208.359.3300
Email:
2. Mechanical Contractor
Under Idaho Bufldtrtg Code, a registered contractor mast do the work for a Commercial Building.
Lewis Corporation
Business:
State License #: HVC-C-4440 5-31-2020
Exp.:
Address: 15136 W Hunzi er Roa
Cin. Pocatello S�aate: a to —
Phone: 208.238.120
Zi Coder--
Email: enyan@lcorp.com P
Contact/Rep. Name: enyan ewis
Phone •238.1202 Email: kenyan@ corp.com
Mechanical ComlactorAuthorized Signature: Date: 4-25-19
A copy ofyourstate registration/license is re
red e an fle. If this is the first timeyou have done work in the City of Rexburg, please provide
a photo copy ofyaur license. Ifyou are unsur
your license is on file, please check with the Permit Technician by rolling (208) 372-2341.
3. Project Description
Address: Madison Middle School
575 West 7th South, Rexburg, Idaho 83440
Description of work: HVAC Upgra e
❑ Project Cost: $ 1
$1288.79
Cost of project:
Calculation for inspection fee:
If project cost is between $0 to $10,000 then:
(Cost of project' 2%) + $60
Ifprojectcost isbetween $14001 to$100,000then:
((Cost0fproject-$10,000)'1%)+$260
Ifproject cost isgreater than $100,001 then:
((Costofproject-$100,000)•54%)+$1160
•^--�•••� •� r��^ =r:�w5�=:� ieyuired which is iun of the calculated Inspection fee
------ -- -•••- pcnany w perjury, inereoy cemrythat i have read 'his 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 Ci ry 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 g
City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the p rovisiosontna the so f t
he
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 IRO days.
Applicant's Name (print):
Kenyan Lewis
Date: 4-25-2019
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 far the next business day.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341