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R&RION BLDG INSP <br /> <br /> FOR CITY USE ONLY <br /> Recciwd By: Date: <br /> <br />L ~TIOR O~ ~0~ <br /> <br /> Pho~ ' ~ <br /> <br />2A, CONTRACTOR INlr OIUViATION --PLEASE INDICATE <br />WHO IS DO[NO THE WORK <br /> <br /> ~g/~on No.: <br /> <br /> P:Ope~y Ow~ ~!~* p~t) <br /> ~t~: 8~: ~P: <br /> <br /> I am Jb~ ~OP~ 0~ a~ own, ~idm la, or will ~s~ ~ <br /> t~ comple~d ~cm~ a~ ~11 b~ m~ o~n generM c~tm~o~ 1 <br /> <br />~cture is ~old or offered ~r ~e ~o~ or upon ~lta'o~ Ill <br />I tt~e Co~ct~n Contractor~ g~rd; ~1 C~¢ my ~ ~ do <br />C~acton ~oa~ I wttl ~tdlatt~ not~ Ma~on Coun~ ~ ~ <br /> <br /> M~RION COUNTY BUI~D]3%TG I~SPECTION <br /> COlVIMUN1TY DBVBLOFMENT <br />3150 ~ Dr. ~ - Suite ~ $a{~, Oregon ~305 <br /> . 8:~- 4:3~m <br /> 24 ~ ~c~n ~e ~?S~27 F~ 588-7~ <br /> <br /> ( ) ~W ( )~DmON <br /> <br />~t~GA~ I ) .~LECTR/C <br />( ) AEr~ATION <br /> <br />~ASYg FE~ A~t~ed on AY~ dJaP~CATION$: $ <br /> A2. Add SU. tO Surchsi'{c (,0~% Z Al + Bale Y~o) <br /> <br />a, ~utet 20~ of Uno A1 fo~ Pl~ <br /> <br />~, Additio~ Pi~ R~vi~w <br /> ~ on~h~ hour) <br />F. l~ai~ for wh;~ no fao ~ s~fm~ly <br /> <br />2__ <br />2__ <br />$ <br /> <br />3. PI. AN ]LEV*I~.W SECTION . O. ln~cdon O~lde Nomal Bu$;~. HOrn, <br />~ ~$ not r~ ~ ~ ~11 p~ pl~ ($~2~, m~i~nl ~o ho~l) S ~ <br />review $~: if you =ompl~ S~on 5B ~d ~t ~ ~) ~ of [ H. Sallie ~o (.0i% x Al)) S <br /> <br /> <br />