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<br /> ''' "�'`. ' Dep:n•tiuent ol'Cansumer fi IIuciness Services :J l)rc<�on
<br /> � IN`. ��'i2
<br /> `. ��r'.�'� Building Codcs Di��isiun • 1�3� L:d�ca�alcr N\1'. Salcro. ��R '� ���,ishin��lou
<br /> ��Le3'" \lailiug address: P.i�. ISo� I-�=170, tialcm, OR 9?30)-U�O�
<br /> =J Idaho
<br /> (;!li�3i&30�i11, i as: liU.;j 3?;-0'_'�S.�1�1��: (�03�3 i t-13>8 :7 Olhel':
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<br /> TYPE aF 1NSPECTION. r`,.. ` <E .,�c,�a.:'
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<br /> �^7 \risual L� In-pla�u �U In-statc ❑ Spcci�il ❑ On-�ite ❑ Jut-of-statc
<br /> ' ": ;. , ,,�y .,.;,�-�,�. {;���'''f��INSP�CTION INFORMATION� ��� � ��
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<br /> .. . .. �%� j��..�� I \C _ r� llaic of mapcctiou.��ra r�{ Datc nquc.sted: � r ,i .�i
<br /> \Ifr nuncr� /� .- / —
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<br /> ! L,�,�� �nst.dlauon lucation:
<br /> ]nspcction locution' ,/� l' � —
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<br /> P.u�l��lo be billed: j;_� C�r � r� ��i�� • /�, : .r ( Contact person: i ��� - -
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<br /> Bilhngaddress�. � '. /' /_' !'-� �f��/ _ � �
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<br /> Inspcctor name����i.-.� /��. • r l L�� • . �' Time in:,� °`- Ti-m-e-o—uci�� It�si�nia issued: ❑1'es Cl Xo
<br /> ❑Cover / � �Pinal . I ❑ Rc-inspcction
<br /> ❑5 -707ll�1190 ❑P-70C,L11191 ❑ 5 - 707II I190 �P-%Ofill I191 ❑S - 70711ll90 ❑Y-70G1I119I
<br /> ❑\I-707ll 1190 ❑ "I:-701ll�1191 U�I -7i�;ll II'i(i J '1- . -0111 II'�I ❑nI i07111190 ❑ *E 70111.11J1
<br /> • "' INSPECTION REPORT '��' � �'x "'�' '
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<br /> I'I�m appro� d uo: --— �c cd uu.----- OIi to co�er ❑1'cs ❑\o J I'
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<br /> ,ns�� n�'s si_m:i�urc: �_ ��� � Tra��cl: �.J Pcnnii
<br /> Incoice to fulimc. luclude p.irmenl I'or all iuspeclions lus��ection lime: � � Tol:ll IloUi's
<br /> perfnrmed during calend:m month.I'a�'menl duc}0 (:unsuRation: _ j �—
<br /> da��s h�om billin�d:�tc. ' -�-�-
<br /> �- �`-���r +ur:h:u��c lsinicl mcch): (-U�1I 17')11 "� 1-hrnn�
<br /> iteccived bp: _'19atr._--�' " _ minimum
<br /> ti''� ,urch:ir��clplmnbingi: i�U�;ll I]`�I! �_
<br /> 1'�� sureh:iree (clecirir�h '--- i (llll I'_911
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<br /> coNsun-��i:
<br /> P,, 3uswr_ss . �
<br /> io. �SERVICES pa,,c' _ _� c��'�_. .
<br /> a-tu-,c,aili ��;�'�-��li I�in� cap�-liillim� ticnrndcnpc-I�ilc �I�hirdcup��-AI:mul�iciur��r - _.
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