Laserfiche WebLink
MARION COUNTY BUILDING 12~;P~ECTION. ~ --[F'~R!~?~ ~:' '~;*-OFFICE~. USE ONLY' ,,] <br /> F~ 588-~48 <br /> BU~D~G PERM~APPLICATi~I0~ ¢0~TY <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 B~i~.O[[~ INSPECTION <br />1. Job Description <br /> <br /> )Addition ( )Relocation [ )Addition ( )Sign ~7~.~ /~e~, <br /> ) Alteration ( )Demolltie~l ( )Alteration ( )De~01ifon <br />(~/~e~e~o~ ( )Other ( )OmngeofOcoupaney ( )Other <br />. '". ............ <br />Tms*(~f,,,, or Rdter( ) I,No, Smffes ] OccupantLeadorNumbe, rofEmployeea No, Bedrooms; <br />Main Floor: [ Other: <br />Sqna~ Pe~t: Basement: I ..... [ sco~d.~oo~: , j~O IH~ghr: //' <br /> <br />Location of Installation q 7dd')t'y <br /> <br />ComractorJnrormatlon <br /> o~, maid* ~. ~ w~ mslde ~ ~* completed <br /> <br /> un~d ~at I mu$t m~s~r as · c~stm~ cmtmc~r ff ~ s~ct~ is sold or offe~ for sale ~o~ or u~n ~pl~fi~, <br /> wig ~ my o~ g<er~ <br /> <br />If I him subcontractors. I will hire only subcontractors registered with the Constnle~ion Contractors Board, If I change my mind ax;d do hire a general contractor, l will contract <br />with a contractor who i~ reglatered withe Coat met/on Contractor's Board, and will immedial~ly notify Marion County of the name of the contraclOr, <br /> <br /> (~ I am a ragiste~d builder OR the authorLzed r~pr~se~ftafive of a mgisl~red builder. -~, ~, ~g}/~'~, ~t'~ ~tr'~>~ ' <br /> <br />I Mai/inS Addr*ss: 'l Phone: <br /> <br />4. Fee Schedule <br /> <br />A. VALUATION' (See I'Valllat~oll Schedule" <br /> to determine valuation based on <br /> square footage,) <br /> (1) Permit Pc* <br /> <br /> (2) 5% State Surcharge (.05 x Al) <br /> <br /> (3) Structural P/an R~view (,65% x At) <br /> <br /> (4) Fire & Lifo Safety Plan Review (.40% x Al) <br /> <br />Valuation: $ ~.~ <br /> <br />B, Miscellaneous Fees <br /> (I) Driveway w/cu/o @ $7.50 <br /> (2) Driveway w/o curb@ $17,00 <br /> <br /> O) Site Plan Review (commcrelal only) @ $79,00 <br /> (4) Additional Plan Review~ or Addendums <br /> (5) hve~tig~tiou Fee <br /> <br /> (6) Relml~¢tion Fee @ $25,00 <br /> (7) Other Inspection~ not lisied above <br />~,c~xrr:__ / 75'5° <br /> <br />MC 15-73 Rev, 11/91 <br /> <br /> <br />