1981, 02-17 Permit: 81A-1368 InspectADDRESS
DATE
INSPDC'I'ION RECORD
REMARKS
PLAN NUMBER
e�
1 2/((/8/ SPO
NORTH
EPARTMENT
a92E0 / 16091466-3676
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB I
f, .r•D1(CPE% o o+ i t ' j- $ N
LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SIKPIVISION ,(•
a 5 13 N IKAI rAL_ Pcnsk4
PARCEL NUMBERS
X9541 - I
t2k1--r Pk•t r.10�
�E016B
ADFE6il�o4 l�ilJcK�'Fi
E9y-.o�
Actual Sot I6o.t. Iart I9" IMM
C01., ,r Ce6
0. IVV�I
PHONE
r
4?e, Xl32 � IiaGNn�✓„
ADDRESS
ZIP
r nkI
-vile- IpY❑V., Onto O R.o .
DESIGNER
S'
PHONEV.lua,30
6 4 MAIM.Ara In Sq. Ft.
A0
ADDRESS
ZIP
.In Floor V Floor.
PP More.
CHANGE OP WE FROM TO
8.
Aro of Docks P10000 /Mame * Unfln. 0apm.nt
_ —
TVPE NEW ❑ALT. AD'N. ❑RPL ❑MVC.
], w ❑ OTHER
WORK 01 OLD. 0 PLIAS. 0 MECH. 0 M.K 0 FOOL
Nn. 00(0, 1 No. Starts No. Rooms No. of Dw.IIIP..
o, ..
CERTIFICATE Rp�o. R.<d. P! i•'
of EXEMPTION
DESCRIBE WORK
" A I
W `—I WJE/`vq—n INj `�—Bx—L--i)
EnunlP •. a cation (Arm)
FEES COLLECTED
...Alta N SOOT 7I OAS EL CTRIC /^WATER`/ EWER
9. IES sl/NI . S
Owner, J USE CODE
Pu0llc ❑ Private Id
I hereby certify that I have read and examined this application and have lead the "NOI II'E' provisions included reverse true
on side, end know the same to be end correct. All provisions of laws and oldin.inces governing this
type of work will be compiled with whether specified herein or not. The granting of a p^rind does not presume
to give authority to violate or cancel the provisions of any other state or local law repuldlnig construction or the
performance of construction. SEE REVERSE7�SIDE FOR REOUIRED INSPECTIONS
SIn01 $
Bulldlnp +�
Plum0109
/�' ,, D/ �,p (n�I
GATE OI APPLICATION _1-9-?. ...__ SIGNATUIRE 00 nPnI ICANT '/r' 67%taJP-4,o47P 444
3.00,
SPECIAL APPROVALS
AME DATE
YECIAL CONDITIONS:
'u
Plan Check
SEPA
11°)M..snnn
M loll H m
Other ISamITIG
TOTAL $
PERMIT NUMBER
e.
024.
02'•' e440A
•4600 M
1294E
02-09+81
s 6479.