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MARION COUNTY BUILDING INSPECTION IFOR (~'FICE USE ONLY <br /> 220 High Street NE l <br /> <br /> BUmD~G PERM~ APPLIC~ l 199t <br /> <br />COMPLETE Ail. SBCTIONS, 1 THROUGH <br /> <br /> 1. Job Description <br /> <br />2. Location of Installation · <br /> <br />3. Contractor Information i , ' , <br /> <br /> ( ) I o~, maidc ~. or wffi m~e ~ ~¢ cmple~ stratum. <br /> <br /> ( ) I on~e~nd ~at I ~st ~s~r as a ~tm~ ~C~ ff ~ S~u~ is sold of Offc~ for sale befo~ Or u~n ~pl6~. <br /> <br /> If I hire mbcontraetors, I will hire only subcontractors registered with thc Constmetlon Contractors Board. If I change my mind and do hire a general contractor, I will conwact <br /> with a contractor who ia r,glstered withe Constmeti~ Contractor's Board, a~d willimmedlately notify Marion County of the n~ne of ~e contractor <br />...... . __ _. .... -,.o..z <br /> (~m a r~gist~ed buildc~ OR [he augo~d r~pr~se.,lta~;v, of~ mgist~n~d builde~ ~ ]e ~, ,Or~- ~ 7 -~0/ <br /> <br /> 4, Fee Schedule <br /> <br />A. VALUATION (See "Valuation Schedule" <br /> m 4¢termine Valuation based m <br /> aquae footase.) <br /> (I) Permit Fee <br /> (2) 5% State Surcha~e (.05 x Al) <br /> <br /> O) Smmural Plan Review (.65% x Al) <br /> (4) Fire & Life Safety Plan Review (.40% x Al) <br />'---fS)~ourcnarge; a applicable (.t/>¥o x Al) <br /> <br />B. Miscellanies Fees <br /> (i) Ddvcwa9 w/curb @ $7.50 <br /> (2) Dfiwway w/o curb @ $17.00 <br /> <br /> (3) Site Plan Review (ccramemial rely) @ $79.00 <br /> (4) Additional Plan ReXdews or Addendm'ns <br /> <br /> (5) Invesligation Fee <br /> (6) P. ehi~pection <br /> <br /> (7) Other Inspections not liated above <br /> <br />m!c q7, b <br /> <br />I hereby cenlfy that tho above in/on'nation is correct and tha~ I have read and Undentand the Informatica NoQee m PrOperty OWners about Construction Respot sibilitie.q on tho <br />reverse side el thisqonn. <br /> <br /> 115-73 Rev, 11/91 <br /> <br /> <br />