HomeMy WebLinkAboutAPPLICATION - 19-00741 - 3737 Taylor Ln - MechanicalRexburg Building Department 31 N 1st E
Rexburg, Idaho 83440
Ph: (208)372-2160
Mechanical Permit Application rexburq.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.
1. Property Owner
Name: /;;ily Ole— -"6
Address: 3 3I T ti /v e— Lu .vim City: State: Zip Code:
Phone: 209- 2 6 ^ ?AV 0 Email: C-1, 'r+ as 1'r/d 2@gJ", at, Y. <a„
2. Mechanical Contractor
Under Idaho Building Code, a registered contractor must do the workfor a Commercial Building.
Business:
Address:
Phone:
Contact/Rep. Name:
State License #:
City:
Email:
Phone:
Exp..
State: Zip Code:
Email:
Mechanical Contractor Authorized Signature: Date:
A copy ofyour state registration/license is required to be on file. If this is thefirst timeyou have done work in the City ofRexburg, please provide
a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling 0208) 372-2160.
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DESCRIPTION OF WORK: ; ' 0 S1 S.4 j u S.e
JOB SITE ADDRESS: 3 4 3—T T 7,10 " ze.
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CITY: i'--rLX j mac, ZIP: L
COUNTY: ` G d i So
DIRECTIONS TO JOB SITE:
AN ADDITIONAL $65 FEE MAY BE ASSESSED if a re -inspection on the project is required.
THIS PERMIT APPLICATION IS NOT AN INSPECTION REQUEST: To schedule inspections please call (208) 372-2344
t 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 andphone number may be providedto a thirdparty upon written request.
DATE:/ -3
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SIGNATURE. PRINTED NAME:
a
Page 1 Revised 7/08/2019
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Rexburg Building Department 31 N 1st E
Rexburg, Idaho 83440
Ph: (208)372-2160
rexburq.orq
MECHANICAL PERMIT WORKSHEET (FEE SCHEDULE)
This worksheet must accompany the Contractor 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 HVAC being constructed on each property.
Calculation for inspection fee:
Based on living space (see definition below)
Cost of project * 2916) + $60
Up to 1,500 sq. ft. $130
Cost of project - $10,000) * 1 %) + $260
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 )
Living Space — space within a dwelling unit utilized for sleeping, eating, cooking, bathing, washing and
sanitation purposes. An unfinished basement is considered part of the living space.
New: Multi -Family Dwelling
Duplex: $260
Three or more multi -family units: $130 per building plus $65 per unit
130 x # of buildings) + ( $65 x # of units )
Existing Residence Detached Shop:
65 dollars plus $10 per piece of additional HVAC equipment (furnace, boilers, wood stoves, factory -built 6
fireplace, gas lines, pool heaters, mini -split system, hydronic system, etc.) and / or exhaust ducts (range
hoods, dryer, exhaust fans, etc.). Fee shall not exceed 'New' square footage fee.
Total Pieces of Equipment
One piece of equipment or exhaust duct is included in the $65.00 fee
Requested Inspection : $65
Plan Check : $65 per hour
COMMERCIAL /INDUSTRIAL
The fees listed under this inspection type shall apply to any and all HVAC 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.
E.
Total cost of HVAC system (Cost of project): $
Cost ofproject: Calculation for inspection fee:
Ifproject cost is between $0 to $10,000 then: Cost of project * 2916) + $60
Ifproject cost is between $10,001 to $100,000 then: Cost of project - $10,000) * 1 %) + $260
Ifproject cost is greater than $100,001 then: Cost ofproject - $100,000) *'r %) + $1160
An additional plan reviewfee is required which is 10% ofthe calculated inspection fee.
b
GRAND TOTAL: $
Please record this fee on the application
Page 2 Revised: 7/08/201c