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~ /) /. . MARION COUNTY BUILDING iNSPECTION <br /> ReceivedSy; ('~-.~ ~]~../~/~.~Z.~,'~_,~.) SeneterBIdg. No. 225 <br /> ~/ .., ~ ~ 2~HlghSt~NE <br /> <br /> Date; ~ '~ ~"' ~ ~ ~ ~ ~ <br /> 5U~LO~G ~N~ICAL PERMIT APPLICATION <br /> <br /> Owner; ~ , P..H0ne: Address: <br /> Situs Address; 8its No.: Cross StReet: <br />q4 - c ....... <br /> M~chanJcal Installer; Phone: Address: <br /> Home Builder,s Registration No.: <br /> <br />2/,ff,/sidentlak '" ....... - <br /> NewJ/[] ' AIt~rati0n: [] ~/~Additi°n: [Z~/'' Reloc~:)n: [] ......... ~ OcoupancyChange: [] <br /> <br /> NO, FEE AMOUNT <br />Base Price 10,00 <br />Forced air furnace 100,000 BTU or less .,. 6,00 <br />Forced air furnace over 1001000 BTU 7.50 <br />Floor Furnace 6.00 <br />Suspended Heater 6.00 <br />Wall Heater 6,00 <br />Floor Mounted Unit Heater 6.00 <br />Heat Pump 6,00 <br />Air Handling Unit to 10.000 cu. ft. 4.50 <br />Air Handling Unit ~ver 10,000 cu. ft, , ...... 7.50 <br />Evaporative Cooler 4.50 <br />Exhaust System Commercial 4.50 <br />Hood and Exhaust Commercial 4.50 <br />Domestic Range Hoods 4.50 <br />Domestic Exhaust Fans & Dryer Vents 3.00 <br />Domestic Wood Stove 7.50 <br /> <br /> NO. FEE AMOUNT <br />C~mmemial or Industrial Incinerator 3010'~'" <br />FiT Damper 3,00 <br />Gas Water Heater 7.60 <br />(~- Connection w/o Appliance 1-4 each 2,00 <br />over 4- $8.00 plus aa. addnl. .50 <br />Appliance or accessory to any heating or <br />,,(~omfort cooling system not covered 4.50 <br />Other (as per Mechanical Code): <br />On-Site Technical Review <br />(Apply at Marion Co. only) <br />Reinspectlon Fee <br /> FEE $//?~-~, <br /> STATE SURCHARGE ' ~e <br /> PLAN REVIEW FEE $ <br /> iNVESTIGATION FEE $ <br /> FLEET SURCHARGE $ .,,,~. ~"~ <br /> TOTAL <br /> <br />Please return COMPLETE APPLICATION with the indicated fee. <br /> <br />~,,,~ I am performing wor~( on a property I own or occupy. SIGNATURE OF APPLICANT: ~)~-~ <br /> [ am ~ registered builder OR ( ) the authorized representative of <br /> a registered builder. <br /> The work will be performed by a registered b~ilder, <br /> Other. <br /> <br />Rev. 3/87 <br /> <br /> <br />