Laserfiche WebLink
/DFOR OFFIC~USE O~LY <br /> Received By: {~5t~ ~g ~ <br /> Zoning Vail&ion: <br /> <br />MARION COUNTY BUILDING INSPECTION 1 F. OR 0~*FICE USE ONLY <br /> <br /> F~588-7948 OUH ~ 0 <br /> <br /> BUILDING PERMIT APPLIC~I?~O01.iN].¥ <br />COMPLaTa ALL SUCTIONS, ] Tm~ouoH 4 <br /> <br />1. Job Description BUItglNG INSPE~;TION <br /> <br />2. Location of Installation 5~Oa/ q~-~'.~'o~2~ <br /> <br />3. Contractor Information <br /> <br /> ( ) I un~nd ~at I must ~gls~r as a ¢~stmcff~ ~n~¢~ ff ~ s~um ~ sol,'or ~d for sa~ ~fo~ or u~ c~pl¢~. <br /> <br />If I hi~ sub~traemn. I wig him only subemtmct~ ~glster~ wi~:~e Cons~on Cmtr~m~ B~. ~ I change my ~ and do ~re a general contractor, I w{g contact <br />wi~ a cmtmcmr who is ~$stemd ~ <br />~tra¢~r Business n~ & ~ M~ Add <br /> <br />4, Fee Schedule <br />A. VALUATION (S~ '/Valuation Seh°dUl~" <br /> <br /> squ~ f~mge,) <br /> <br /> (1) P, mit F~ <br /> <br /> (2) 5% State Sumha~e (,05 x Al) <br /> (3) Structural l~an ~vigw (,~% x A1 ) <br /> <br /> (5) 7~mthg Surcha~e. if apphcable (,05% x A 1) <br /> <br />: i {Mamgaaa~**: [Fbo~ <br /> <br /> l B. MiScellaneous Fees .... <br /> (1) ay lc <br />.Valuation: $ ,~_~__.0 C2) Ddwway wi0 cu~ <br /> ~8.50 <br /> ,/* ~ O) ~te Plan R~ew (cmmerci~ rely) ~ $79,~ <br /> (4) Additional Plan R~hews or Addcndmns <br /> <br /> = ~ (6) R~s~fim Fee <br /> = ~ ~) O~er~s~efims not,steal above <br /> <br />I hcrcby certify that the above information is correct and that I have mad and understand thc Information Notice to Property Owners about Construction Rcsponsibil/ties on the <br />MC 13-73 Rev. 11/91 <br /> <br /> <br />