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Building Department (208) 647-7086 2020 Park Avenue Burley, ID 83318 Building Inspector Plumbing Inspector Electrical Inspector HVAC Inspector Gary Mark Floyd Gary (208) 431-5425 (208) 650-1258 (208) 650-1098 (208) 431-5425 Please fill out this application completely and submit with payment. If you have questions or need assistance completing the application please call the Building Department. Please note: permit fees are non-refundable and non-transferable. Applicant Information Property Address of Construction Owner: Address: City State: Zip Code: Email: Contractor Information Name: License # : Address: City: State: Zip Code: Email: Phone Type of Work New Addition Alteration Repair Roof Move Remove Describe Work: Valuation of Work: $ Building Permit Fee: $ DATE: SIGNATURE: PRINTED NAME: Amount you are enclosing: Please bill my Credit Card: Visa Discover Card MasterCard Signature: Card # : Exp. Date: 3 Digit Sec. Code: Your security code is located on the back of your credit card, next to the signature box. Page 1 SIGN SIGN ---PAGE BREAK--- HVAC PERMIT WORKSHEET (FEE SCHEDULE) This worksheet must accompany the Contractor/Homeowner 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. * 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 □ 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 х # of additional 1,000 sq.ft. or portion thereof ) $ • New: Multi-Family Dwelling (Contractors Only) □ Duplex Apartment $260 □ Three or more multi-family units: $130 per building plus $65 per unit ( $130 х # of buildings ) + ( $65 х # of units ) $ Existing Residence Modular, Manufactured or Mobile Homes Detached Shop: $65 fee plus $10 per piece of additional *HVAC equipment being installed up to a maximum of the corresponding sq.ft. (one piece of HVAC equipment is included in the $65.00) $65 + ($10 х # of additional pieces of HVAC equipment ) $ Gas Line Kitchen Range Hoods : $65 $ Solid Fuel/Gas Fuel Appliance: $65.00 per inspection $ Hydronic Heating: $65 + ( $10 х # of zones ) $ Exhaust Fans – Bathroom and/or Utility : $65 $ 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. $ Total cost of HVAC system (Job Value Amount): $ □ Up to $10,000: (total cost of system x 0.02 ) + 60 = $ □ Between $10,001 - $100,000: ((total cost of system – 10,000) x 0.01 ) + $260 = $ □ Over $100,001: ((total cost of system – 100,000) x 0.005 ) + $1,160 = $ GRAND TOTAL: $ Please transfer this fee to your 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. * Examples of HVAC Equipment – furnace replacement, solar, etc. Page 2