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FOR OFFICE~USE O~LY] <br />Zoning Validation: ~ [ <br /> <br />MARION COUNTY BUILDING INSPECTION_J FOR OFFICE USE ONLY <br /> <br /> 0 3 ./z ,, , <br /> <br /> BUILDING PERMIT APPLiCATION...~-,, <br />COMPLETE ALL SECTIONS, 1 THROUGH4 ~ION uuur, I~ <br />1. Job D~crlptlo~ BUILDING INSPE~T,0N <br /> <br />2. Loeatioltof~stallafion . ~'~.Y~ ~.,,a£~' <br /> <br />3. Conteactor/~uformation <br /> <br /> ) I own, reside in, or will msldc in the completed stractu~, <br /> ) I under~tand that I must regi~mr as a oonstructic~ contractor ffthe struc~t~ is sold or offered for sal~ b~for¢ or upon completion. <br /> <br /> ) I will be roy own g~eral contractor, <br /> <br />If I him subcontractors, I will hire only subcontractors mgisteroo5 ,wi& the~C°ns~O Ccatractors B~M, ~ I chang~ my ~nd and do ~c a g<cra{ contra~, I will ~ntract <br />wi~ a c~c~r who ........... i$ ~ste~d <br /> <br />4. F~ Schedule <br />A. VALUATION ($¢e 'Valua6Vn $~cdule" <br /> <br />to determine valuation based on <br /> <br />square footage.) <br /> <br />(l) Permit Fee <br /> <br />(~) 5% Stem Surcharge (,05xA1) <br /> <br />(3) Stractural Plan Rcvlcw (,65% x Al ) <br /> <br />(4) F~m & IAfe Safety Plan Revlew (.40% x Al) <br /> <br /> ~B, MJscdlaneoas Fees <br /> <br /> '= (6) R~s~cfi~ Fca ~ $25.00 = <br /> (~f applicable (,05% x A 1) ~¢~'~ ~) O&er ~s~c~s not ~sted above - ~ <br /> <br />[5;~bc[ ~ff~&f~&~: tf ~a b o v e tnfo~m ~s ~mct =d ~at I have mad md undem~d ~e Mfomatim Notice m Property OwneN about Cmstmc~on Respm sibili6es on ~e <br /> <br />S[g,,ah, mofAppllcam: fi h~¢k w,th Mar --Dale'. ? ~ 7-'~ 7 ~r~''' <br /> Site evalaatkm% septic, electtieal, plombing and mechaaical work require ~e~ta e p~rmb_q. ~ ' io~1 County Buildfilg Impection be[om ~ubmittlag this app~¢~6 <br />MC 15-73 Rev. 11/9/ <br /> <br /> <br />