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MARION COUNTY BUILDING INSPECTION IFOR OFFICE USE 6'NLY 1 <br /> 220 High Street NE ~ ,j C~it~ SetBack ~eqtilrementa: <br /> <br /> numbed PERM APPLICATIO s ] ~ <br /> <br />COMeLET~ ~LL SECTIONS, t vm~ouo~ 4 MA~tl0N C0U NIY <br />I. Job Description B01IDiNG INSPECTION <br /> <br />RESIDEN'tiAL cOMME~CiAL ( )New '"~se of Stmem~e; <br /> ( )Addition ( )Rfl~afion ( )Addition ( )Sign~/~' ~~f~ff~ <br /> ( ) Demohfi~ ( ) Ahcraaon ( ) Demo~fim <br /> ece~s~ ( )~her ( )~angeof~cu~ey ( )Other <br /> <br />'l~.*s(~ or Ralwr( ) , I Nd. Stories, ~ / , IOecupantLoa~orNumberofEmPlo~es Nd. flatfoot,ts[ <br /> <br />2. Location or'Installation <br /> <br /> PfivatoWell ( ) Spring <br />Lot Wid~ ~ / : L~ Depth ~ ~ Acres i~*g, ~[ ~ Comer Commu~ty Wall (,) City <br /> <br />3. Contractor Information <br /> <br /> ¢I o~, ra~id~ ~. or will ~e ~ ~e condole ~t~u~, <br /> <br /> ( ) I wi~ be my O~ gmeml contmetm. <br /> <br />Archimct name: ] Mailing <br /> <br />Fee Schedule <br /> <br />A, VALUATION (See "Valuation Schedule" <br /> <br /> (1) l)crmit <br /> <br /> (2) ~% State Surcharge (.05 x Al) <br /> <br /> (3) Smmumil Plan Review (,~% x Al) <br /> (4) Fin & Life Safety P/an Review (,40% <br /> <br />= .,,/. ?J <br /> <br />B. Miscellaneous Fees <br /> (1) Driveway w/curb @ $7,50 <br /> <br /> (2) Driveway w/o curb @ <br /> <br /> (3) Site Pla~ Review (commercial only) ¢~. <br /> <br /> (4) Additional Plan Review~ or Addendums <br /> <br /> (5) Investigation Fac <br /> <br /> (6) R¢inspecdon Fee @ $2~,00 <br /> <br />MC 15.73 Rev. 11/91 <br /> <br /> <br />