Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br /> <br />FOR OFFIC_~,USE~ QNLYl <br />~Received by~~ <br /> <br /> , : 220 High Street N~ ~-~ [FOR OFFICE USE ONLY. <br /> /t9t <br /> <br />MANUFACTURED STRUCTURE pLA~T0 <br />PER~T APPLICATION <br /> <br />COMPLETE ALL SECTIONS, 1 'rHI~OUGH 4 <br />L Job Desch ~on MARDN COUNTY <br /> <br />2. Location of Installation <br /> <br />3. Contractor Information <br /> <br />( ) I own, resldc in, or will reside in [he complctcd structur~i <br />( ) I Imderatand that I must r~gls~r as a ¢Onstmcllo~i contractor if the sttuctur~ is sold or offere41 for sale before or upon completion. <br />( ) I will be my own gmcral contr~c, tor. i ' <br /> <br />If I him subcontractom, I will him only subcontracio~ registered with the Constmchon Cmtractors Board, <br /> <br />If l! change my mind and do hire a §eneral contractor. I will cxmkract Mth a contractor who i~ registered with the Construction Contractor's Board, and will <br />immcdlate2y ngtify Marion ~ounty of thd,,~me'ofth, ~ontmcton /~t~}2 t?~' ,.,grog. ~aad 3 a re <br />Contractor Business Name & <br />( ~am a registered builder OR the authorized <br /> <br />4. Fee Schedule ' <br />A. (1) Manufactull~il Home ' : I <br /> o,~o~m~ u~i,~=~c~e~io~ ~ sxsa.d0 <br /> <br />B, (1) Mfg.'d Stmctom Storage Fee <br /> (2) Mfg.'d Structure Storage Rme,,val <br /> <br /> (3) ~Omg Surchal,ge (1 $ O0 if applicable) <br /> <br />Mailing Address: ~ .. <br /> <br />@ S60. m=___ <br /> <br /> C. Addltional Inspection <br /> or Reinspection ' <br /> <br /> D, investigation Fee: <br /> <br /> @ 40,00 per hour (2 hour minlxnura ) <br />@ $ 25,o0 = <br /> <br />@ $4O,O0= <br /> <br />@ '25,00= ' <br />@ <br /> <br />TOTAL= $ O¢~3~'~ <br /> q 7c~d <br /> <br />on thc reverse si&* of this form, <br /> <br /> MC 15-64 Rev II-91 <br /> <br /> <br />