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] FOR CITY VALIDATION1 BUILDING INSPECTION DIVISION <br /> <br />[Date: __ [ 24 HR Inspection Line 373-4427 <br />~~* .~q t Ofll~: phone 588-5147 8:00am - 4:30pm Issued by: <br /> FAX 588-7948 <br /> <br />· ICAL PERMIT APPLICATION ~ULE Corn me--oral In Al below <br />-- A. Residential Per Unit Items Coal (each) Sum / <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> TAX ACCOUNT NO. <br /> <br /> JOB ADDRESS <br /> <br /> CITY <br /> <br />PROPERTY OWNER <br /> <br />CROSS STREET/ <br />DIRECTIONS <br /> <br />PROJECT DESCRIPTION <br /> <br /> D EXPIRE IF WORK IS NOT 1 <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br /> Contractors LicenseNo. ~ I~ ~ I~ ~ ~ C <br /> <br /> Sig~ture of Supv. ~l~ci~~ <br /> <br />2B, FOR OWNER INSTALLATIONS <br /> <br /> Property Owner (please print) <br /> <br /> Mailing Address <br /> <br /> City, State, Zip <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> Marion County does not require a plan review. <br /> We will provide plan review service if you complete <br /> Section 5B and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br />MC 15-34 7/97 <br /> <br />Serviee Included: <br />10~ sq. ft. or less $85.00 4 <br />Each ad~itiona/500 sq. ft. <br /> or portion thereof $15.00 <br />Limffed Energy $20.00 1 <br />Each Manufactured Hom~ or <br />Modular Dwelling S~rvlce or Feod~r $40.00 2 <br /> <br />In~tatlatlon, Alteration or R~locatlon <br />200 amps or less $50.00 2 <br />201 amps to 400 amps $60.00 2 <br />401 amps to 600 amps $100.00 2 <br />601 amps to 1000 amps $130,00 2 <br />Over 1000 amps or volts $300.00 2 <br />Reconnect only $40.00 <br /> <br />IFirst brauch circuit ~ $35.00 <br /> <br />5. FEES <br /> <br />B. Enter 25% of line Al for Plan Review <br /> (Sec. 3), if required <br />C. investigation Fee (if required) <br />D. Reinspection Fee ($25.00) <br /> <br />Receipt No.__ <br /> <br />TOTAL AMOUNT DUE <br /> <br /> <br />