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MARION COUNTY BUILDING INSPECTION ]~R OFFICE USE ONLY <br /> [Clt~ SCthaCk Req~drements: <br /> <br /> 220 High Street <br /> <br /> Code-A-Phone 588.7904 <br /> <br />BU~D~G PERM~ APPLICATI0~ <br /> <br />COMPLETE ALL SECTIONS, I THI>.O/UGH 4 COUNTY <br />1. Job Description ~[I!} <br /> <br />RESIDI[NT[AL CO P, CIAL ) New use oI ~tmeture: <br />( )Alteration ( )Demolition ( )Alte, ta~ion ( )l~molition i~ole-'"~a¢ldt~) ,=,o~K3d <br />0}2JeA¢¢essory ( )Other ( )ChangcofOecupaney ( )Other <br /> <br /> ' ) ,, , <br /> <br />2. Location of Installation <br /> <br />Subdivision ~ Bilk <br />.... Pfiva~W~l[ ( ) Sp~g ( ) <br /> <br />3. Contractor Information <br /> <br />) I own. msltie in. or will mside in the completeti $lmctul~. <br /> <br />) I undemtand that I mint re,stet as a eonst ructie, al ¢ontrador ff ~I~ atmatug is sell{ or offered for sate bdor¢ or alma <br /> <br />) I will b~ my o'ma g~a~end oontraO, ot. <br /> <br /> If / hi~ mbcontractors. I will hire only subcontractors registered with the Construe{ion Contractors Board. If I e,,hange my n~nd and do }dfc a general contractor. I will contract <br /> v.4th a contractor who is r~w~.th~ Cons3metlon Conttaetoea BOal~l. and will immediately ned~y Marion County of the name of th,: contractor. <br /> <br />} (b'~flamar~g~mmdbullderORth~auth°rm~drept~senraav¢ofar~g~temdbuilae,t. ,o~,e~/t~ ~f~f. ~73'~'/~'~ <br />I A~'~ "a~*'/~ C-~ '~ / ,.~m-Ll~&ro J Ma/,l~g Aadm~$. {Phone, <br /> <br />4. Fee Schedule <br /> <br />A. VALUAT/ON ($¢* "Valuation Schedule" <br /> <br /> sq~a~ footage.) <br /> <br /> (I) Permit F~ <br /> <br /> (2) 5% Stag Surcharge (.05 x Al) <br /> <br /> (3) Structural Plan Rovicw (.65% x Al) <br /> (4) Fire & Life Safety Plan Review ¢40% x ^1) <br /> <br />Value{lin: $ <br /> <br />B, Mhcdlaneous Fees <br /> (1) Driveway w/~m~ @ $7.50 <br /> <br /> ~) Driveway w/o cu~ ~ $17,~ <br /> <br /> O) ~m Plan Redaw emlm~rdal only) ~ $79.~ <br /> <br /> (4) Additional Plan Rehews or Addmdums <br /> <br /> (5) ~v*sfigafi~ Fee <br /> <br /> (6) R~efi~ Fee ~ $25.00 <br /> <br /> (7) O~cr~g~cd~$ not ~sted above <br /> <br /> <br />