HomeMy WebLinkAboutAPPLICATION - 19-00421 - University and S Yellowstone Hwy - New Traffic Signal31 N list E
° Rexburg Building Department Rexburg, Idaho 83440
i Ph: (208)372-2160
'•`s„r0 .••' Electrical Permit Application rexbura.ora
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: City of Rexburg
Address: 35 North 1st East City: _Rexburg State: ID Zip Code: 83440
Phone: 208-372-2331 Email: joelg@rexburg.org
2. Electrical Contractor
Under Idaho Building Code, a registered contractor must do the work for a Commercial Building.
Business: Mnnntain West Flertrir. Inr _ State License #: _EL : c-3Ro2 Exp.: 12 1 /� 2n1 g
Address: 586 W Hwy 26 #1 City: _ Blackfoot State: ID Zip Code: 83221
Phone: 208-684-5463 Email: dbrown@mtnwestelec.com
Contact/Rep. Name: Dana Brown Phone: 208-684-5463 Email: dbrown@mtnwestelec.com
A copy ofyour state registration/license is required to be on file. If this is the first timeyou have done work in the City of Rexburg, please provide
a photo copy ofyour license. If you are unsure if your license is on file, please check with the Permit Technician by calling (208) 372-2341.
DESCRIPTION OF WORK: Signal Install
JOB SITE ADDRESS: University Blvd and S Yellowstone Hwy
CITY: Rexburg
DIRECTIONS TO JOB SITE:
ZIP: 133440
COUNTY: Madison
JOB NAME: _Rexbure University Signal
AN ADDITIONAL $65 FEE MAY BE ASSESSED if a re4nspection 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 numberis regarded as public information
according to the Ida oPublic Records Act. Yourbusiness address and phone numbermay be provided to a third party upon written request.
Electrical Contractor Authorized Signature: Date:
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Page 1 Revised 7/08/2019
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Rexburg Building Department Rexburg, ID 83440
(208) 372-2160
rexburg.org
ELECTRICAL 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
'r—# -i d
• New Residential: Single Family Dwelling, including all associated outbuildings in connection with primary or
secondary residence (i.e. Accessory structures, Additions).
* 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
0 3,501 to 4,500 sq.ft. $325
❑ Over 4,500 sq.ft, $325 plus $65 for each additional 1,000 sq.ft. or portion thereof
$325 + ( $65 x # of additional 1.000 sa.ft. or oortion thereof )
• The building plan review fee will be 10% of the total cost for the Building Permit
• Temporary Construction Services ONLY (200 amp or less, one location): $65
$
• New: Multi -Family Dwelling
❑ Duplex Apartment $260
❑ Three or more multi -family units: $130 per building plus $65
perunit ( $130 x # of buildings) + ($65 x # of units)
$
❑ Existing Residence ❑ Manufactured or Mobile Homes:
$65 fee plus $10 per additional branch circuit, up to the maximum of the corresponding sq.ft. of the
$
building (one circuit is included in the $65.00) $65 + ( $10 x # of additional branch circuits )
• Residential Electric Space Heating and Air Conditioning $65.00
$
• Pumps -Water, Irrigation, Sewage each motor): ❑ 65 up to 25HP o 95 - 26 to 200HP o 130 over 20 HHP
Phase inverters and roto phase equipment, please use the Other Installation including Commercial/Industrial fee
$
in addition to the Pump motor fee.
• Residential Spas, Hot Tubs, Hydro Massage Tubs and Swimming Pools: $65 fee for each trip to inspect
$
• Use Other Installations below for non-residential installations
• Signs/Outline Lighting: o Signs - $100 per sign o Outline Lighting - $65
$
• Temporary Amusement: $65 fee plus $10 per ride, concession, orgenerator
$65 + ( $10 x # of ride/concession/generator )
$
• Irrigation Machine: $65 for center pivot plus $10 per tower or drive motor
$65 + $10 x # of tower/drive motor
$
❑ Requested Inspection
(Findings or Inspector Consultation) Contractor cannot call in for power off over 1 year.
$65.00 per hr
OTHER INSTALLATIONS Including COMMERCIAUINDUSTRIAUSOLAR/RENEWABLE ENERGY
• The fees listed under this inspection type shall apply to any and all electrical 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 st;,.plied by others. At the time of
"Final' inspection, the scope of work, valuation, and permit fees will be verged.
Total cost of electrical system (Cost of Project): $ $144,000.00
$
Cost of project: Calculation for inspection fee:
If project cost is between $O to $10,000 then: (Cost of project' 2%) + $60
If project cost is between $10,001 to $100,000 then: ((Cost of project - 510,000)' 1 %) + $260
Ifprojectcost isgreaterthan 3100,001 then: ((Costofproject-3100,000)''fa%)+31160
An additional plan review fee is required which is 10% of the calculated inspection fee
GRAND TOTAL: $
Please record the grand total on your building 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 7/08/2019