1980, 06-06 Permit: 80-4258 InspectAPPLICATION/.PERMIT '4
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APPLICANL. f.OMPIETE NUMBERED SPACES EII1U TO MAKE 3 COPII S
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DEvONER
▪ ADD.ESS
926 31
LEGAL DESCRIPTION — SEE ATTACHED
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Location (Ara.
SOURCE
UtrigiES
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USE CODE
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OF, IF sus !CATION q -z9. 8a
VECLALAPPROVALO SPECIAL CONDITIONS.
NAME DATE
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FEES COL LIMO
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S Ie 62.00
SEPA• L
O Mn (Ponhl
TOTAL •GZ.°v
0
INSPECTION RECORD
OWNER
LOCATION
CONTRACTOR
NSE W
SET BACKS
TYPE OF WORK
FINAL INSPECTION•
DATE REMARKS:
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