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./], /, MARION COUNTY BUILDING INSPECTION <br />By:: <br /> Senator Bldg, NO. 225 <br /> 9.20 High Steel NE <br /> <br />MARION C,~I.~MBiNG PERMiTAPPLICATION <br /> <br />Owner:; Phone:: Mallin~ Address;; . ¢.f <br />~b Address' ' 8i{~"No ' C~OSS St~et; ~/~, ~ <br />....... ,,, ,, <br />Plumbing Inst~ller. Phone;: Add,ss:: <br />Home Builder's Reglstra~ion No :: <br /> <br />Residential'. ~ New;: "~ '" Addition;; D ~upan~ UseoYBuiJding:: ~ <br /> <br /> NO FEE AMOUNT <br /> Sase Price <br /> Residential <br /> 'N~W construction !each fixture) $ 90o <br /> Alterations (each fixture) 9.00 <br />Re-lo~ated Residence each fixiure) 450 <br />Commercial <br />Ne~.Const;~c~ian (each fix!.~re) ' ~..00 <br />Alterations (es, ch fixture)... 900 <br />Water Lines <br />. For the first 100 f~et or fraction thereof '" 20.00 <br />For add.!ti0na1100 feet 1500 <br />First 100 feet or fraction thereof 30..00 <br />Additional 10{:) feet 1500 <br />Mobile Home sewer~vater connection <br />(maximum 5 ~et length) 25,00 <br />Other (a~'~er OSPSC ~.nd Buildin'g Official) /~ ~ ,.~/~, ¢( <br />On-Site Techr~.ical Review (apply at Marion Courtly 0nly) <br />I Re-lnsp~gtion Fee 25.00 <br /> FE~' $ <br />STATE SURCHARGE <br />PLAN REVIEW FEE $ <br />INVESTIGATION FEE <br />Please return COMPLETE APPLICATION FLEET SURCHARGE $ ~""~.~ <br />with the indicated fee. CITY FEE $ <br /> <br />) lamareOisteredhuHderOR( )theauthorlzedrecresentatlveof 81GNATUREOFAP <br />} Other <br /> <br />MC 15-45 <br />Rev 12/~7 <br /> <br /> <br />