HomeMy WebLinkAboutAPPLICATION - 07-00010 - 110 E 1st S - ElectricalBuilding Safety
Department
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City of Rexburg
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REXB RG
19 E Main ionellh@rexburg.org
Phone: 206.359.3020 x326
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America's Family Community
Rexburg, ID 83440 www.rexburg.orrg
Fax: 208.359.3024
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0700010
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PROPERTYADDRESS it /Soot
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SUBDIVISION
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PHASE LOT BLOCI<�
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ELECTRICAL
Electrical Contractor's Name Da".gi_,�L L �F�FeS Business Name
Address �% e7 %Goo 2, CityeerState - Zip 93vra
Cell Phone (,2o6) .39d G S7S Business Phone (Zog) -3r5Z' L.Scl
Fax ( ) Email
Electrical Estimate (cost of wiring & labor) $ (COMMERCIAL/MULTI-FAMILY ONLY)
TYPES OF INSTALLATION
(New Residential includes everything contained within the residential structure and attached garage at the same time)
/06 Up to 200 amp Service*
201 to 400 amp Service*
Over 400 amp Service*
Temporary Construction Service, 200 amp or less, one location (for a period not to exceed 1 year)
. Existing Residential (# of Branch Circuits)
Spa, Hot Tub, Swimming Pool
Electric Central Systems Heating and/or Cooling (when not part of a new residential construction permit
and no additional wiring)
Modular, Manufactured or Mobile Home
Other Installations: Wiring not specifically coveted by any of the above
Cost of Wiring & Labor: $
Pumps (Domestic Water, Irrigation, Sewage)
Requested Inspections (of existing wiring)
Temporary Amusement/Industry
*Includes a maximum of 3 insp cnons. Additional inspections charged at requested inspection rate of $40 per hour.
Signature of Licensed Contractor
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License number Date
The City ojRexburq'r permit fee schedule is the same as required by the State
P. 1
M�io�ry TX Result Report ( Jan. 11. 20&10: 31AM )
2)
Date/Time; Jan.11. 2007 10:31AM
File Page
No. Mode Destination Pg(s) Result Not Sent
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3481 Memory TX Rocky Mtn Power P. 1 OK
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Reason for error
E. 1) Hang up or 1 i ne fa i 1 E. 2) Busy
E. 3) No answer E. 4) No facs imi 1 e connection
E. 5) Exceeded max. E—mail size
Building Safety Department �a* CITY o,
My of laxburg REXBURG
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OWNE&ISNAME A PROPM YAMR0700010
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pPIUSE ISIOQJ I,oI. B,ar{ 60 91 Q E 1 st S-Kelly
Requiredlll EL rC WCA.L
McCain, Con— N=CDA&eA14 Aninm Nam
Addms �! E asaa � tsty .Pe�y6.�Ststie .�s zp 8.30,..
QU Phone Caog) _:"-d L 87J' Basieersa Phone (,&g) _ _ 4,9C LSyg
Fax ( ) 8msd
EIecuk d Eitimme(coacivitbga kbw) $ (COMMERCEM4MULTI-FAMILY ONLY)
717M OPRO ALrA27ON
(1VPe��t�dw�d�ooS,dEse.a�eawLrbin deemdd�dd�rene�mo�d�d�x�cudbarme�
1e4 Up t*200:mp Sayscc*
201 to 400 gasp Seevicc*
Over 4W seep Service*
Temporary Construction Service, 200 arap or bm% one loaaon (for a period not to emceed 1 ym)
Ad== Eusdog Rwdaidd (# of Branch Ciutrits)
Spa, Hot Tub, Swieamaiag pod
Rectrie Centeal Sot= Hra44and/or COO&V N_ -a pat �arw nr oo a p it
and m addidooal.ddm�
i Msreafiteamed or Mobile Haan
Other InsuRatioaer Wh ing not spodfrc Uy covered by aey afrhe above
Cost of Wnurg do Label $
PUMP (13omestic Wate; IaigaW% Sewage)
Rccp=Wd IOspe cdons (of ezisdM whino
Tetnposssy Aemamo�t/htdetstry .
*Iseiodes a ma imam off iuep 'out..tddriooslinspoe�oas duWd as aquomd kvccdm ma of J40 pee bom
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Sgnsauc ofIiuesved Caaoormr ]iemso aeeaebv Date:
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