Laserfiche WebLink
OFRCE USE ONLY <br />Received <br /> <br />1. LOCA'nON OF INSTALLATION <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 220 High Street NE <br /> <br /> Phone 588-5147 8:00 a.m. - 4:~o p.m. <br /> Cocle-A-Ph~-e: 586-'/904 SITE #: <br /> F,~X: ,~8-7948 <br /> I <br /> <br />Mailing Add~e~ ' <br /> <br />~ gn~re of ~uperv ~ing Ele~trioian <br /> <br />Propet~ Owner <br /> <br />The Installation is being mede on property I own whioh is not Intended for sale, <br />lease or rent. <br /> <br />Owner's Signature <br /> <br /> Perm t No <br /> <br />Issued by: <br /> <br />4. FEE ~CHEDULE (Complete and enter tolal in A1 below) <br /> <br />A. Residential, Sitlgle or Items x 13o~t _- Total <br /> <br />Multi-Family per dwelling unit <br /> <br /> Ea~ M~.'d HO~ or M~u~r <br /> <br /> l~a~ <br /> <br /> R~n~ Only <br /> <br />D. Bmnoh Clmul~ <br /> <br /> One cimult <br /> Two ~ ~n ~1~ <br /> E~h ~d'l ~n oimuim or p~on <br /> <br />E. ~s~llaneou~ <br /> <br /> E~ pu~ or Irdga~n ~cle <br /> <br /> Sign~ cimult(s) et a U~ enemy <br /> <br />F. ~eh e~'l Ins~Son <br /> <br /> P~kof 10 ~ ~ $5.~ e~h <br /> <br /> (~ ~ by ~i~ng <br /> <br />$85.__ 4 <br />$ 15. <br /> <br />$35,__ ?. <br /> <br />$80, 2 <br /> <br />~$3~. 3 <br /> ,,, $ ~6. ~ 2 <br /> <br />__ $3e,__ 2 <br /> <br />$50, <br /> <br />PLAN RE%qEW ~iEG'I1ON <br /> Check appropriate/tam and enter fee/n ~ca~/t 5B, <br /> <br />Connected Load over 200 amps (except single tamily dwellings) <br />Building system over 200 amps (except single family dwellings) <br />System over 600 volts <br />Building over 2 stefles <br />Building over 10,000 ~cluam feet <br />Ooeupent ~d over ~ ~rsoas <br />Manufaotumd ~[i~ P~a~n Pa~k <br />Hazardous ~ns <br /> <br />Submtt 2 sets of plans wi~ any c~ ~e above. <br />Temporary oonstruoflon services do not apply. <br /> <br />& FI=I:R <br /> Al: I::nter t~ta] of:feeskom:Seo. ~, <br /> A~, Add 6% SUre (,OSx A~) <br /> <br /> B. Enter ~r~efli~e At lot Plan Review <br /> (Sec, a[ ]f reqbired <br /> O. Investigalio~ Fee :(if required) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />Sr <br /> <br /> <br />