HomeMy WebLinkAboutAPPLICATION - 19-00662 - 890 W Main - Grind Coffee House - Electrical04 ggXB URG
>> ° Rexburg Building Department 31 N 1st E
Rexburg, Idaho 83440
N� Ph: (208)372-2160
Electrical Permit Application rexburcg.org
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.
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1. Property Owner
Name: Al'I
QAddresCity:
Phone:(
State: 14D od. i
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2. Electrical Contractor
Under Idaho Buildin Code, a registered contractor must do the work for a Commercial) uilding.
Business: b State License #: �'5 ) � Ex l' ���/
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Address: City: State: _rD— ZiR Code: q
Phone:Q016-
CAW
OQ 3i�- 4�✓{o Email:
Contact/Rep. Name: a0 Phone: •?)9. 3 mail:_kL4,9=_ =-;
A copy ofyour state registration/license is required to be on file. 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) 372-2341.
DESCRIPTION OF WORK: '64
JOB SITE DRESS: (% e";
ZIP: 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.
Electrical Contractor Authorized Signature: Date:
Page 1 Revised 7/08/2019
Rexburg Building Department
ELECTRICAL PERMIT WORKSHEET IFEE SCHEDULE
This worksheet must accompanythe Application
RESIDENTIAL
31N1stE
Rexburg, ID 83440
(208) 372-2160
rexburg.org
Use this worksheet to calculate the fees and transfer the grand total to the
e application.
• New Residential: Single Family Dwelling, including all associated outbuildings in connection with primary or
secondary residence (i.e. Accessory structures, Additions).
Total $
* 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
$
113,501 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 SQftor portion 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 ❑ 95 - 26 to 200HP ❑ 130 over 200HP
Phase inverters and roto phase equipment,
$
please use the Other Installation including Commercial/Industrial
in addition to the um motor fee. 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: ❑ Signs - $100 per sign ❑ 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 drivemotor
$
$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 supplied by others. At the time of
"Final" inspection, the scope of work, valuation, and permit fees will be verified.,,
Total cost of electrical system (Cost of Project): $ SCJ
Cost of project: Calculation for inspection fee:
If project cost is between $0 to $10,000 then: (Cost of project -29%) $$60
If project cost is between $10,001 to $100, 000 then: ((Cost of project - $10,00
10, 000) * 1 %) + $260
If project cost is greater than $100,001 then: ((Cost of project_$100,0 $100,000) * % %) + $1160
An ndditinnnl nlnn rte,,,,,.. F .. :
.- • -,z . — .......1 IJ l u no vl 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 7/08/201.c)