HomeMy WebLinkAboutAPPLICATION - 19-00647 - 408 W Main - Gas lineo� RExs vA�
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° Rexburg Building Department
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Plumbing Permit Application
31 N 1st E
Rexburg, Idaho 83440
Ph: (208)372-2160
rexburq.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:
State: Zip Code:4 D
Phone:
Email:
2. Plumbing Contractor
Under Idahuilding Code, agistiered contractor must do the work for a Comm cial Building.
Business:/ %� to Lic nse #:7YOI�,�b
Address: Exp.:
Phone: j} - - v City: G State:_ Zip Code: �4
Email: / /
Contact/Rep. Name: �f�� Phone- U — a_i2%lQ
A copy ofyour state registration/license is required to be on frle. 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)
372-2160.
DESCRIPTION OF WORK:
JOB SITE DDRESS:
CITY: ZIP: )q3yyL COUNTY:
JOB NAME:
DIRECTIONS TO JOB SITE:
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.
-1lumbing Contractor Authorized Signatur :C Date: 42 �l 7
Page 1 Revised 7/09/2019
O�gEXB URC
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�A Rexburg Building Department 31 N 1st E
' Rexburg, Idaho 83440
Ph: (208)372-2166
rexburq.orq
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
• New: Single Family Dwelling, including all buildings with plumbing being constructed on eachproperty.
* Based on living space (see definition below)
1 oral
If project cost is between $0 to $10,000 then:
❑ Up to 1,500 sq.ft. $130
If project cost is between $10,001 to $100,000 then:
❑ 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 portion thereof
$325 + ( $65 x # of additional 1,000 sq.ft. or portion thereof )
An additional plan review fee is required which is 10% of the calculated inspection fee.
• 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 buildines) + ( $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 for sewer and water stub connections
❑ Requested Inspection ❑ Water Heater Replacement as Line : $65
❑ Water Conditioning Equipment: $65.00
❑ Lawn Sprinklers: $65
$
$
$
$ U
$
$
❑ Hydronic Heating: $65 + ($10 x # of zones)
$
COMMERCIAL/1NDUSTRIAL
• 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 (Cost of project): $
Cost of project:
Calculation for inspection fee:
If project cost is between $0 to $10,000 then:
(Cost of project * 2 b)+$60
If project cost is between $10,001 to $100,000 then:
((Cost of project - $10,000) *191o)+$260
If project cost is greater than $100,001 then:
4
((Cost of project - $100,000) * i2 %) +$1160
n a onal plan review fee is required which is 10% of the calculated inspection fee.
GRAND TOTAL: $ /A.5', Dd
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