1981, 03-30 Permit 81A-2318 Inspect7
3
ADDRESS
INSPECTION RECORD
DATE REMARKS S
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E.115419 BwoGCPoi
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
IA BRIOCiihRT
LEGAL DESCRIPTION - SEE ATTACHED
p7DD0 EPGT
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CONTRACTOR
91AII16
424E 1x51
PARCELNVMOER/S
eeessa-es Is
ZIP
etiziG
AOWISSa
D ESIGNER
S' ADDRESS
ZIP
Arta. s.r serer. In ran
Nate La I.nrthJ L.,t 20. Iw..t CRaNAuNon
RES. MoBlL.E 1brnE
Sate
nCI z US
Tye Ere..
Oaop.nq
A-1
SpmeNrW
Oyn ONO 0 RATA
PHONE
gyaIlore
suuMIM Area In So. rt.
4110
SIP
Main Fin. I urn. FF.. Parma Area
leo
Store..
1
CHARM[ OF USE FROM ITO
N of Ds . I Plnlahee MNment
uaM. Iseern.
TYIrI ri1 NSW 0 ALT. 0 AO'N. 0 RPL
�T lWDI1R lY ISLIP, 0 PURL 0 MICR. 0 M.M.
O S90RIs[ WORN •
& VZ UT�OM W R
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0 MVE.
❑ bol LJ OT
NO. Bal
1
r 0. S[Nln No.. Rooms
CERTIPICATI 5.54. I Rema. Sia l�
a exEMFTIDN I r
No. 0 Dvnlllnes
!num. Old.
LOrauen (AroN
SEWERWATER
Soft".
Ow.rMla
Iweur ❑rerun. Iltf
WE CODE
I hereby certify that I `have read and e,.mined this application and have read the "NOTICE ulovlsIons Included
on reverse ride, antnnow the same to be true and correct. All provisions of laws and .,Idlna,Aes governing this
type 0f work will be Complied with whether spangled herein or not The granting of a 11 rnnl doer not presume
t0 give authority to violate or cancel the provinons of any other state or local law reeulnnng LonitruClmn 01 the
p.rfofmance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
•
DATE OF LIGATION LT/ O/ SIGNATURE OF APPLICANT JyILEs i
RECIAIAL APPROVAL'E YECIAL CONDITIONS: -
n t DATE MA.. 'CO
.n
Flr. Marthatr
cd Engineer
R..lo•
0lan. E...nIn..
FEES COLLECTED
SI aR
SulldhM
Plumbing
Wen.
PNn Check
SOA
Mobil. Hon.
Other !Specify)
P
�Z6®
TOTAL $..118.
PERMIT NUMs[R
SVA -.231,r
02• •2t;0C
•2800'
•280.0
A •000 8
2137?
03-06-81
? 6479
. ,alE[4wlena.
WHEN MACHINE VALI0ATEO IN 11410 SPACE,
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