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# <br /> FQR CITY VALIDATION MARION COUNTY BUILDING INSPECTION FOR CITY USE ONLY <br /> - y'~ . · j ] COMMUNITY DEVELOPMENT CENTER <br />[P,.¢cei'~ed~yl ~~_.1~I 285C~Sa~elhSI. NE- Room132 2ity~kR~quir*m~s: <br /> ..... <br />Zoning Vah~tton: <br /> <br />, <br /> <br />COMPLE~ ~ SE~ONS, 1 THROUGH <br /> <br />1. JOB DESC~P~ON <br /> <br /> ( ) New Singlo'Fami~ D~Hing W~ Detaeh~ ~ge <br /> <br /> ( ) New Duplex <br /> <br />{ ) <br /> <br />4. FEE SCHEDULE <br /> <br />VALUATION - Based on squ~e foo~e: <br /> <br /> B. PERMIT FER$ <br /> 2. Stat~ surCharge ($% orA- I ) ~ <br /> <br />5, lnv~ti~fion F~ (1.~5 ~ ~ ~) ~$ ; <br /> <br />Dwelling labels must be obtained at Marion County Building Inspection and must be placed at the Job$1te prior to inspection for plumbing, electrical and <br />mechanical work. Contact Marion County for instructions. <br /> <br />I hereby certify that the above information is correct. Pc[mjB are non-tmnsfarrable and expire if work is not started within 180 days of issuaaoe or if work is suspended for <br /> <br />Name of Applicant (Please Print): ~"" /./Y ~_.~/.ff _~/ (p(J. <br />Signature of Applicant, : : ~__~.~. Date: ~l~*~ <br /> <br /> <br />