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FOR oFFICF US .ONLY <br />Received By: <br /> <br />MARION COUNTY BUILDING INSPECTION iFOR OFFICE USE ONLY <br /> 220 High Street ~ -, .~1 city serba*k R~q~,~r~t~,'~: -- <br /> ~'~y ~ ~[~ ~ ~ W/I~ I~ar: <br /> <br /> F~ 588-7948 ~'- - ~ ' <br /> PERM~ APPLICA~N~nO ~ <br /> BUmDiNG <br /> <br />COMPLETE ALL SECTIONS, 1 TI-~OUGH 4 MARION COUNTY <br />1, Job Description BUILD]NO It/$PEOT ON <br /> <br /> RESIDF2'rlIAL C0~ERCIAL (" ') New Use of S,me't'ar~; <br /> ( )Addition ( )~a~ ( )Addi~ ( )Sign ~/~ 1~ <br /> <br />.y~¥( ) or ~ter(~ ,[ ,No.S~o~s / ~ff~tLmdo~um~rof~pi~ea <br />""'='"" " ' I O ,r, <br /> <br />2. Location of Installation <br /> <br />3. Contractor Information <br /> <br /> (~ I om, reside ~, m ~l msld* ~ ~d'~omple~ stm~u~, ' <br /> (,),I un~nd ~at I must ~ster as a constmcfim comncm ff fie s~U~ is sold or offered for sale before or u~n <br /> (~I w~ be my om gme~ c~tm~or <br /> <br />If I Mm subcontractors. I will hire only subcontraetom rcgistereA wi~h [he Consh-u~on Contractors Boaril. IfI change my mind and do Mrc a general contractor. I will contract <br />wi[h a cc~traetor who Js registered withe Construction Contractors Board, and will immediately notify Marion County of the name of th~ contractor, <br /> <br /> ( ) I am a registered builder OR [he au[hol~zed i'c, taesentatlve of,a r~gisl~md builder. <br /> <br />AtcKile~ name: I MaLilng Address: [ Phone: <br /> <br />4. Fee Schedule <br />~i VALUATION (See "Valuation Schedule" <br /> <br />squa~ footage.) <br />(1) Permit Fee <br /> <br />(2) 5% State Surcharge (,05 x Al) <br /> <br />(3) Structural Plan Review $65% x A 1 ) <br /> <br />(4) Fie~ & Life Safety Plan Review (.40% <br /> <br />Val.ation: s <br /> /7,.5'0 <br /> <br />(I) Driveway w/curb @ $7.50 <br /> <br />('2) Drlveway w/o curb @ $17.00 <br /> <br />(3) Sit* Plan Review (commercial only) @ $7%00 <br />(4) Additional Plan Rehews or Addendm-ns <br />(5) Invcstigatical Fee <br /> <br />(6) RoAnspe.¢tim Fcc @ $25.00 <br /> <br />(7) O[hcr Inspections not listed above <br /> <br />MC 15-73 Rev. 11/91 <br /> <br /> <br />