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~'"'7"T;' .............. .............. ] MARION COUNTY BUILDING INSPECTION <br />' I~OR. CITY I{~R ONLY ' <br />~ r, ~ 3150 Lancaster Dr, Nl~ -Suitc C <br /> <br />t ~C~P~T~PLICATIONi~ ~ tiO'~/ ~. ~:~ · ,,, , <br /> <br />[PE~ ~ NON.~SF~ A~ ~I~ IF WO~ <br /> IS NO~ ~ W~ l~ DAYS OF I~5~AN~ OR IF <br /> WOR~I5 5~5PE~gD FOR 180 DA~, <br /> <br />2A. CO~R ~FO~TION <br /> <br />~ ~R O~R ~ITION <br /> <br /> Pro~ ~cC ~e <br /> <br /> l~: <br /> <br /> you complem ~ecfou 5B and subz~ two (2) se~s of [ <br />st~cteastlons w;~ this appUcatlon. <br /> <br />Al. Enter tornl of ~ees ~om Sec, ~4 <br />A.2, Add State Surcharge (.05% x Al) <br /> <br />SIJ~TO~AL <br /> <br />B, l~ot~r 30% of linc Al f6r I~an Rcvlew <br />C. ~v6i~gagon r~ (if req~d) <br />D, gcias~cfion F~ (~0.~) <br />E. Addition~ P~ Review (~2.5~ <br /> minimum on~h~[ ho~) <br />F. hs~fi~ for w~ch no fee is specific~y i~c~ <br /> <br />O. Inap~on Ou~ide No~ Business <br />($52.~0A~, ~mum ~ ho~) <br /> <br />TOTAL AMOUNT DUE <br /> <br /> <br />