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03/27/98 .FR[ 09:46 FAX ! 508 §88 7948 MARION BLDG INSP ~001 <br /> <br />· MARION COUNTY <br />I FOR CITY VALIDATION I BlnI,on~o II~SPECTION O~IO~ ~ ~O: <br /> <br /> [ [ 3150 Lancast~ ~. ~ - Suite C <br /> IR~iv~ By: [ S.e~ Omgon ~7~5-1398 Date: <br /> [ ' O..: ph,~ ~am - 4.*m Issued by: <br /> <br /> [ ELECT~ICkL PEHMIT kPPLICATION [ (~ ' --E ..... co ~ ...... ' <br /> I Please complete all Secfions, lt~rough ~PRy { 1~ )8 <br /> l. LOCATION OF INSTALLA~ON ~RION COU TySOn" l=l~,a: I~, ~t (.=h} sum <br /> <br /> AO~SS t'{34 z--r5 <br /> <br />CITY <br /> <br />· OWNER <br /> <br />3ROSS STREET/ <br />DIRECTIONS " <br /> <br />PIH~VlITS ARE'NON-TRANSFERABLE AND I~XPIRE IF WORK 15 NOT <br />STARTB~) WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSpFA~DF.D FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> ~.,co.,,.,o~ ~,.,~f.e ff/.~d'-',c /~ c <br /> Mailing A~ress~) /'~07a' ~"~ ~ OtYi <br /> <br /> . <br /> <br />2B. ~R OW~R ~STALLA~ONS <br /> <br /> ~ Owner ~le~e print) <br /> <br /> Mailing Ad,ss <br /> <br /> Cily, State. Zlp <br /> 1'1 I I-I ,I I i-[ I I '"'1 <br /> O~r's 8~nam~ <br /> <br />3, PLAN REVIEW SECTION <br /> <br /> Marion County does not require a plan review. <br /> We will provide pian review service if you complete <br /> Section 5B and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br />Limited l]nersy S~0.00 ,. <br /> <br />$. FEF_,S <br /> <br /> · A2, Add 5% ~,umha~e (,05 x Al) <br /> <br /> (Sec. 3), ir reqaim:l <br /> <br />Subtotal <br /> <br /> TOTAL AMOUNT DUE <br />Receipt Ho. . <br /> <br />__¸2 <br />__2 <br /> <br /> <br />