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MARION COUNTY BUILDING INSPECTION <br /> <br />FOR. OFFIC~ ]JSE ONLY <br />Zoni"~ Valmti°"' ,5-X/~ <br /> <br /> FOR OmC us .1 <br />8:~am.4:3~~7 Fmnt~ ~t ]Rear: ~7~ / <br /> <br />PER~T AP~T~9N ~ ~U <br /> NOV. ) ~ <br /> <br />COiVlPLI~TB ALL SECTIONS, 1 TI-1ROUGI~I 4 <br /> <br />Location of In,qmlladon ~{e ?-'qq -000 <br /> <br />3, Contractor Information , , <br />( ) I o~. msMc ~, ~ w~ ~side h t~ c~e~d s~, <br /> <br />If I hire *uN;ontractofs. I ~ hi~ only sutn~ontractor~ reglstcred with th* Cons ~t~uct~oa ContractOn Board. <br />If !cNmg¢ my mind an~l do him a general comrac~or, ! will c~ntrac~ with a cc~avtor who i~ mgist*r*d with tho ComtmcO. on ContractoF~ Flol~rd, and will <br />imm.dlamly no~y Marion coumy of the name of the con[ra~tor. ~o~'~ 'i <br />C. vnuactorBmlnessNamc&#: ~,~ ~,~a..' ~ IMailingAddmss: } [~-'~.:~ jug, Il ~fC~ [Phone'.'Tiq_ 77z/g <br /> ~) I am a ~§istcmd b0ilder OR thc authoriz, cd mpfescntaQvn of a l~gistcmd buildcn <br /> <br />C, Addltionallmp~tion @ $60.00 =__ <br /> or Relmpecfion <br /> <br />D. I~v,stigation F~e <br /> <br />~ ~0.00 i~r honr (2 hour minimum) <br /> <br />@ $40.(X1 = ~ <br /> <br />Name of Applicant (please phnt)'f\ P['~Z~ t''O ~r~/f ~t' : Phone: <br /> <br /> <br />