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)R CITY'~VALIDATION| MARION COUNTY BUILDING iNSPECTION <br />:eivedBv: ~. ' ~ //~.~.~'v'~ t,e_. 2~.~Chu~chSLNE - ~132 <br />. ~ ~ ~ ' '1 ~o~, <br />ming V~on: { 8:~m~ ~o~ ~S147 <br /> <br />~pL~"r~ A,L <br /> <br />OB DESCRIPTION <br /> <br />~ FOR CITY USE ONLY <br />'~ ~' ~' ~" I <br /> <br />~tOE~'d. CO~C~AL MARION OOU~d~¥ u~, ors~,~: <br /> <br /> ( )Al~fion ( )O~t ( )Alta.don <br /> <br /> ( )Ac~ ( )~leof~cu~ ( )Other <br /> <br />.OCATION OK~S~ ~LLA~O~ <br /> <br />CONTRACTOR IiVFORIVIATION -- PLEASE IIxrDICATE V~-IO IS DOING THE WORK <br /> <br />FEE SCH]~DULE <br /> <br />(5) ~(.~% x Al) <br />(6) .~e~mi~ <br /> <br /> ?.12- <br />/.:..I. 0'7 <br /> <br />(2) Inve~ijn(i~o Fes <br /> <br />(3) Rein,pec~m Fee ~ <br /> <br />he~..by certify that the above infonuafion is correct. <br />'e~rni~s are non-transferrable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. <br /> <br />lial~ of Applicant (PI~s~ ~,~ <br /> <br /> <br />