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FORCITY VALIDATION| MARION COUNTY BUILDING INSPECTION | 'FOR CITY USE ONLY <br /> " ~-,~ ~ .... 't t~tl COMMUNITY DEVELOPMENT CENTER <br /> <br /> BUILDING PERMIT APPLICA~I~ <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 ~ ... <br /> cr]-o0 OILvi, t JIvn, <br /> <br /> RESIDF/qTIAL COMMERCIAL <br /> ( ~ition ( )~l~afion ( )A~ition ( <br /> ( ) Alteration ( ) O~er ( ) Al~mtion ( ) Sign <br /> ( )Accesso~ ( )Ch~geof~pancy ( <br /> <br />~y ~: J No. Stories [ No. of ~ploy~s: ~isfing - New- [ No. B~s: <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> ( ) I am the PROPERTY OWNER and own, r~sld¢ in, o~ will reside in the compl~l*d stm¢lur~ and will be my ow~ ~n~ml co~or. I ~ that I must t~gha~r m a ;olmmietion <br /> <br />~ <br /> <br />4. FEE SCHEDULE <br /> <br />on square footage of proj~t.) <br /> <br />(1) Permlt Fee <br /> <br />(5) ~n~g Sumac. if appfi~ble (,05% x At) ~ ~ = <br /> <br />xtyr ~c~ - S <br /> <br />I hereby cenfify that the above information is correct. <br />pexmils are non-transferrable and expire if work is no~ started within 180 days of issuance or if work is suspended for Ig0 days. <br /> <br />MC 15-73 Rev 1195 <br /> <br /> <br />