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[FOR OFFICE USE ONLY <br />]Received By: ~'-~t ~} ~g~m~-- <br /> <br />MARION COUNTY BUILDING INSPECTION I FOR OFFICE USE ONLY <br /> 220 High Street NE ~f~'~[t~ I City sabaa Req~i~me.;'~: .... <br /> <br /> $:00am-4:30pmPhoneSg8-5147 ~Le, ftSid~' ~ ' : ; · / <br /> <br /> FAX 55s-7948 <br /> BUILDING PERMIT APPLI~Nc00i,~. t <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH <br /> <br />1, Job Description <br /> <br />RESIf)ENTL~L COMMERCIAL ( )New Use of Structure: <br />( )Addition ( )Relocation ( )Addition ( )Sign <br />( ) Aherati(m ()Demolition ()Alteration ( ) Demolltion <br />~?Aecesso~ ( )Other ( )Chang~ofOc~opancy ( )Other ....................... <br /> <br />T~s/( ) et Raftec( ) I No,$to~e, ]O¢¢upantLoedorI~uml:~rofEmployees lNo, Bedrooms: <br /> <br />2. Location of Installation <br /> <br /> I~c,,~,~,a:~!a, 0c~. q7525 <br />Sub~ivlsion Let Block <br /> <br />Scaion To~/~p ~ge Z~e Map Water Su~[y: <br /> "~,,~,"~, co~ c~,~>, w~ ( ) Ca,y <br />Lot <br />Widm <br /> Lot <br /> Depm <br /> <br />3. Contractor Information <br /> <br /> (~) I o~, msid* in, or ~ ~siO~ m the mm~dt~ stm~u~, <br /> ( ) I under.nd ~at I must ~s~r ag a ~stmcfi~ c~cmr ~ ~o s~u~ is sold or offend f~ sfl~ before ~ u~n <br /> <br />If I hire suboontractom, I will him only subcontractors registered with the Construction Contractors Board, If i change my mind and do hire a general contractor, i will COiltFact <br /> <br />/(~I am a resismred buJld¢~ OR ~le authorized mpreser~ative eta msismred bt~lder, <br /> <br />4. Fee Schedule <br /> <br />A, VALUATION (See "Valuation Schedule" <br />to detenuine valuation based on <br />square footage,) Valuation: <br />(1) Permit Fee <br />(2) 5% State Sumhaqge (.05 x A 1) -- <br />(3) Structural Plan Review (.65% x Al) = <br />(4) Fire & Life Safety Plan Review (.40% x A I) = <br />(5) 7aoalng Surcharge, if applicable (.05% x A I) = <br /> <br />B. Miscellaneous Fees ~ (I) Driveway w/curb@ $730 <br /> <br /> (2) Driveway w/o curb @ $17,00 <br /> <br /> (3) Site Plan Re~ew (cmme~el rely) <br /> <br /> (4) Additional Plan Renews or Addmdms <br /> <br /> (5) ~vesfigafi~ Fee <br /> <br /> (6) ~s~cfim Fee ~ 525,00 <br /> (7) O~er~s~c~ot ~sred above <br /> <br />reverse side q~ this form, , <br /> <br />MC ~5-73 Rev. I1/91 <br /> <br /> Phone: _'7 ~I,-77L{L]{, <br /> Dato: <br /> <br />Check with Macon County Building lnspe~ion ~fom ~u~itt~g ~is application. <br /> <br /> <br />