1981, 02-03 Permit: 81A-978 InspectC INSPECTION RECORD
ADDRESS
DATE REMARKS
42 -3 -Si 5 Aez
1e
,.,y&1115p 7 ; NO6
Ottle Fie•of//11i2�
N NUMBER
l? f/z9/
SPOKA
ARTMENT
NORTH. 09/ 450.3076
APPLICANT: COMPLETE NUMBERED SPACS — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
2.
LEGAL DESCRIPTION — SEE ATTACHED
a -2"ed—u'n.s
PHoNE
92E-9'3614
ZIP
PARCEL NUMBER/S ;35'4, 4- 4.30 7
Al./ '9,0 3.20'or 6. 4T .0)5/5/5/45 0
•
1i/.
Fi-Ar FARMS "PR, TR/0017.S
Actual Sal Bacirs In Feet .
North C,-.3 ISoutn31 I est 1w ,3/5
PHONE
ADDRESS
„Of.z9.944.1_,
DESIGNER
6' ADDRESS
CHANGE OF USE FROM
ZIP
Size of Perm
•pp
Type Cons/.. VicCupanclf
5--/k/
Zone Classification
.P.L4I.Lif54.44/
Sprinidered
Oven Onio CD Redid.
ZIP
TO
100110/ Building 0,05 1,l 50. Pt.
Ad -art,
Floor kUplinir Floors 0•J.0/•S
-4MqArea of
St.2age
Finished Easement 1 unfin. Basement
TY" op NEW 0 ALT.
7. OF
wo,, 131-13. 0 01,19.
51 AWN. 0 RPL. 0 MVE.
0 MECH. 0 M.H. 0 POOL
0 OTHER
a ro=t..,-
WAr'"7ral" SEWER
SOUgrtf OAS fELECT RIC
traWIJ ,
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Ran'd. 1 Sac, lient)rd.
Enurn. Dist.
Location (Areal
Owner..
Puizna 0 0,Nale
USE CODE
1 hereby rut nty that 1,6,100/ e0456onn II:6 app, o ',BOBS InClin/P11
or-to/else side, atni know the sawn to he nue arid dltutovisionK ::t laws .16:1 ,,,, I novertuoy DI,
type w1,l6 will 1,0,1,, 111 nliuthur .per o hun ii1 uni
run torninuoi inni Bit Lon SEE REVERSE SIDE FOR REOUIR ED INSPECTIO
IJATE 01 1_11, I li• r,1 ...Pi
SPECIAL APPROVALS
NAME DATE
0111101.
SPSCIAL CONDITIONS:
FEES COLLECTED
9,
Plumbing
Mech.
Plan Check
SEPA
1101111
C 7
6479
Other (Specify§.-.
r 9.2-42-
70TAL
WHEN MACHINE VALIDATED IN THIS SPACE,