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P/ease comp~e a//Solons, I through 5 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> Phone 588~t 47 8:00 a.m~ - 4:30 p.m. <br /> <br /> FAX: 588.7948 <br /> <br />Property Owner <br />Mailing Address <br /> <br />The installation is being mede o~ prober~ I own which Js not Intended for sale, <br />lease or refit. <br /> <br />Owner's Signature <br /> <br />3. PLAN REVIElli/9ECllON <br /> Check ~ item and enter [se in Sec~n SB. <br /> <br />.. Connected Load over 200 a~ll~ (exm~pt ~ngle family dwellings) <br /> Building system over 200 amps (exoept single family dwellings) <br />__ System over 600 volts <br />__ Building over 2 $ledes <br />__ ~ui~ing over 10,000 square feet <br />-- Occupant load over 300 persons <br />__ Manufactured Dwelling park~llon Pa~ <br />__ Hazardous Locations <br /> <br />Submit 2 set~ of plane with any of the above. <br />TemPera['/conswc~on smvices ~ not a~ly. <br /> <br />$ 'rE #: Permit No. <br /> <br />Dale: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDUEIE (Complete and enter total in A~ below) <br />Number of InapM~flonl per ~rmlt all~ <br /> / <br />~ ~sl~nttst, Sl~ts ~ I~ x ~st = To~I <br />~la~a~lly ~r d~llng unit <br /> <br /> 1~.~.~ ~ $ ~. ~ <br /> E~'l~O~,ff,~po~n ~ $ t5. <br /> E~ M~,'d Ho~ or M~I~ <br /> D~li~f~r ~ $ ~. ~ 2 <br /> <br />B. <br />(~0~~) <br />~a~ ~s ~. ,~ 2 <br />t01 ~~ , $~, 2 <br /> ~l~e~ S ~, . 2 <br /> ~la~b 1~ .. $1~, ~ 2 <br /> ~1~0~0~ ~ ~. ~ 2 <br /> <br />~ Tem~m~ ~ts~ere <br /> <br /> ~er ~ ~s or 1~ ~lts (~ 4B) <br /> <br /> N~, A~ ~ E~ ~ P~ <br /> ~eeimult ~ $ ~. 2 <br /> T~ ~ ~n ~1~ ~ $ ~. ~ 2 <br /> <br /> (~F~~ <br /> E~ pu~ or ir~a~on ~e $ ~. ~ 2 <br /> Ea~a~n~outlinel~hang ~ $ ~. , 2 <br /> 5ign~ clmult(s) or a aml~ enemy <br /> <br /> ~er ~ ~1~ in any of <br /> · e~,~ln~n ~ ~ ~- ~ <br /> <br /> (8o~ on~ ~ e~l ~) <br /> <br /> (~ ~ by ~i~ ~) <br /> <br /> <br />