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IFOR OFFI'CE USE ONLYI <br /> Received By: ~ .1 <br /> Zoning Validation: <br /> Dale: .&2 -/~/- 57f <br /> <br /> COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br /> 1. ,Job Description <br /> <br />MARION C OUN:I:~r~)~G~PECT ION <br /> <br /> BUILDING INSPECTION <br /> <br />[FOR OFFICE USE ONLY <br /> <br />I~ft Side: ~'-/, I Right Side: "~- r <br /> <br />(XNew Single Family Dwelling w/garage <br />( ) New Single Family Dwelling w/o garage <br /> <br />(/O/Garage, attached <br />( ) Garage, detached <br /> <br />Tru,q$(t/)~ or Rafter( ) <br /> <br />2. Locationoflnstallation ~Fte~ d] 7Jd~ <br /> <br />Mobil~ Home P~k $~c~ g <br /> Private Woll ( ) Spring ( ) <br />~W~dth ~ t L~D~h/~, ]~ A~es ~eg.~ Cm~ ~ CommumtyWctl( ) City <br /> <br />3, Contractor information <br />Pr °P*r t Y Ow ncr X/,4~,~ ~ ~ <br /> <br />I Mailing Addresa { Phone No, <br /> <br /> own, ~esid~ in, or will reside in the completed structure. <br /> <br />I uad*rstand that I must register a~q a construct/on eontraeter if the ~tmaur~ i$ gum {x offered for sale before e¢ upon completion. <br />will b¢ my own general eontracto~, <br /> <br />If I hire subcontractors. I will lfire only sul:~ontract ors registered with the Cot~stm~ion Contractors Board. If I change my mind and do hire a general Contractor <br /> <br /> who i~ regi.qterod with the Construction Contractor's Beard. I will immedlat~l~notify Marion County of the name of the eoatraco,: <br />-- 1~- /G <br /> <br /> ¢'~) ! am a registered builder OR the authorized rep~entafive of a {egistered builder. <br /> <br /> "~Ye ~ iO~verz <br /> <br />4. Fee Schedule <br /> <br />A. New One-a~td-Two Family Dwelling <br /> (inleud~s El, Me, PI) <br /> <br />(3) PI~ Review <br /> <br />Valuation: <br /> <br /> <br />