HomeMy WebLinkAboutAPPLICATION PLUMBING - 19-00260 - 242 E 6th N - Tami's Salon - BeutofullnessRexburg Building Department 31 N 1st E
Rexburg, Idaho 83440
s, Ph: (208)372-2160
9e`�SNED Plumbing Permit Application rexburp.orq
Please fill out this application completely and submit with payment. If you have questions or need assistance completing the application, please call the
Rexburg Building Department. Please note: permit fees are non-refundable and non -transferable.
1. Property Owner
Name:
Address:
Phone:
2. Plumbing Contractor
Under Idaho it/d}}'ng Code !registered cont
Business: J [ (S w
Address:
Phone: G g
Contact/Rep. Name:-- ^
City:
Email:
State: Zip Code:
ust do the work for a Commercial Building.
$tate License #: Exp.:
City: v State: Zi Code: 2 d
Email:
Phone:
Email:
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Plumbing Contractor Authorized Signature: Date:
A copy of your state registration/license is required to be 41e. If this is the ►rst 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) 372-2160.
DESCRIPTION OF WORK:
J o
JOB SITE ADDRESS:
CITY:ZIP: COUNTY:
(If known) LOT: BLOCK: SUBDIVISION:
OWNER EMAIL ADDRESS:
JOB NAME:
DIRECTIONS TO JOB SITE: ��[,!�—!;•tid Spry.-� 1 ��j�
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AN ADDITIONAL $65 FEE MAY BE ASSESSED if a re -inspection of the project is required.
THIS PERMIT APPLICATION IS NOT AN INSPECTION REQUEST: To schedule inspections please call (208) 372-2344
It is the responsibility of the permit holder to arrange access to the premises with the property owner in order for the city
to complete the inspection.
We Accept: cash, check, money order, Visa and MasterCard GRAND TOTAL FEES PAID*
Make checks payable to the City of Rexburg
*Please use the worksheet on page 2 to determine the total fees and enter the amount to be paid here.
PUBLIC RECORDS NOTICE — Business information such as your company address and phone number is regarded as public information
according to the Idaho Public Records Act. Your business address and phone number may be provided to a third party upon written request.
DATE:
SIGNATURE:
PRINTED NAME:
Page 1 Revised 7/09/2019
O�g6XB URC
Rexburg Building Department 31 N 1 st E
0
Rexburg, Idaho 83440
Ph: (208)372-2166
rexburg.org
PLUMBING PERMIT WORKSHEET (FEE SCHEDULE)
This worksheet must accompany the Application. Use this worksheet to calculate the fees and transfer the grand total to the application.
RESIDENTIAL
Total $
• New: Single Family Dwelling, including all buildings with plumbing being constructed on each property.
* Based on living space (see definition below)
❑ Up to 1,500 sq.ft. $130
❑ 1,501 to 2,500 sq.ft. $195 Total Square Footage
❑ 2,501 to 3,500 sq.ft. $260
$
❑ 3,501 to 4,500 sq.ft. $325
❑ Over 4,500 sq.ft. $325 plus $65 for each additional 1,000 sq.ft. or portionthereof
$325 + ( $65 x # of additional 1,000 sq.ft. or portion thereof )
• New: Multi -Family Dwelling
❑ Duplex Apartment $260
$
❑ Three or more multi -family units: $130 per building plus $65 per unit (Contractors Only)
( $130 x # of buildings ) + ( $65 x # of units)
❑ Existing Residence ❑ Detached Shop:
$65 fee plus $10 per additional fixture, up to the maximum of the corresponding sq.ft. of the building
$
$65 + ( $10 x # of additional fixtures ) (the first fixture is included in the $65.00)
• Sewer & Water: ❑ $65 Sewer Line ❑ $65 Water Line ❑ $65 Sewer & Water — if inspected at the same time
❑ $65 Sewer turnaround / Domestic water (change from septic to city, water re -pipe under house)
$
❑ Modular, Manufactured or Mobile Homes: $65 foi• sewer and water stub connections
$
❑ Requested Inspection ❑ Water Heater Replacement ❑ Gas Line : $65
$
❑ Water Conditioning Equipment: $65.00
$
❑ Plan Check: $65 per hour
$
COMMERCIAUINDUSTRIAL
• The fees listed under this inspection type shall apply to any and all plumbing installations not specifically mentioned
elsewhere on this form. This shall include all labor, materials, equipment, overhead and profit, as well as all labor, materials,
and equipment supplied by others. The project value cannot be reduced by labor, material or equipment that is donated or
supplied by others. At the time of "Final' inspection, the Scope of Work, valuation, and permit fees will be verified.
Total cost of plumbing system (Job Value Amount):
❑ Up to $10,000: ( total cost of system x 0.02 60 =
❑ Between $10,001 - $100,000: ( (total cost of system — 10,000) x 0.01) + $260 = $
GRAND TOTAL: $ 3
Please record this total on the application
* Living Space — space within a dwelling unit intended for human habitation which may reasonably be utilized for sleeping, eating, cooking, bathing, washing,
recreation, and sanitation purposes. An unfinished basement is considered part of the living space.
Page 2
Revised 7/09/2019