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FOR OEFICE USE ONLY <br />R~eivext <br />Zoning Validation. <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 220 High Street NE ,~ , ,., <br /> <br /> Code-A-Phone 588-7904 ~ ~ <br /> <br />FOR OFFICE USE ONLY <br /> <br />Lf~?id¢:[.~,, '-- {Rj. ghtSide:_5- / <br /> <br /> BUILDING PERMIT APPLICATION <br />COMPLETE ALI. SECTIONS, 1 THROUGH 4 MARION C0U NJY <br /> BUILDING INSPIZCTION <br /> <br />1. Job Description <br /> <br />RESIDENTIAL COMMERCIAL ( ) New <br /> <br /> ( ) Addition ( )Relocation ( )Addition ( )Sign <br /> <br /> ( ) Ahcn~tion ( ) Demolition ( ) Alteration ( ) Demolition <br /> ) Accessory ( ) ~ange of Occupancy ( ) Other <br /> <br />Tm~s( ) or Rafter( ) 'x O¢cupantl.oadorNumberofEmplo¥¢¢* <br /> Other: <br /> <br />2. Location oflnstallation <br /> <br /> Site No, <br />Section ~ 6~ TownsUp ~ Range ~ ~ Zme ~ ,~ Map ~ Water Supply: <br /> ..... privateWell ( ) Spring <br />t.otwlam Lo~ Depth Acres I~eg. ~r Comer ~ C mmun vWe~ ( ) Chy <br /> <br />3. Contractor Information <br /> <br />4. Fee Schedule <br /> <br />A. VALUATION (See "Valuation Schedule" <br /> <br /> ~quare fc×)tlrge.) Valuation: <br /> (1) Permit Fee <br /> (2) 5% State Surcharge (.05 x Al) <br /> (3) Structural 1 lan Review (.65% x Al) <br /> (4) Fire & Life Safely PLan Review (.4(1% x Al) <br /> <br />B. Miscellaneous Fee~ <br /> (I) Driveway w/ourb@ $7.50 <br /> <br /> (2) Driveway w/o curb @ $17.00 <br /> <br /> (3) Site Plan Review (commercial only) @ $79.(X) <br /> <br /> (4) Additional p[an I'~eview~ or Addendum~ <br /> <br /> (5) ~wesilga~i~ Fee <br /> <br /> (6) ReNs~ctim~ Fue @ S25.00 <br /> <br /> (7) O~her D~s~chons not ~stcd ahove <br /> <br />TOIM. $ <br /> <br />reverse side of this form, <br /> <br />MC 15-73 Rev. 11/9I <br /> <br /> <br />