1981, 05-14 Permit: 80B-4772 Inspect,ADDRESS
INSPECTION RECORD
DATE REMARKS
3 -IV -IP{ ?tic.� /je fi c 7//J
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.2//e/go
O NE WASHINGTON 60260 / MOW 4563675
APPLICANT: COMPLETE NUMBERED SPACES PRESS )) IItr; TO MAKE 3 COPIES
TEL �
,UEUIVI,IDN 361t/i
ADORE
1. 7
ANTRA TORS
O
9NE2�-2942
LEGAL DESCRIPTION — SEE ATTACHED
RCELENA 44,.S43 -34/2
08' Lio-it
OICC ARD AVE ADD
Actual
s In Fast
tb 40' 'south 643/ Ieast 39/ Lex 14'
PHONE
last of 6,5�X /OS/
ono OftsallIcaca
Typo Cons
ADAeLli
Occupon
Sore, wee
Ov.. ONo 0 R.03.
DESIGNER
ADORES,
�2^ �o
Building Area)n So. Ft.
90
9oF,Upoor OWN riorsoo ao I SI_.
NANO
TO
Araa of Docks
NINO E•..m.nt
Uens. Remount
OPPE NEW 0 ALT. ADS,0 RPL 0 PAVE. 0 OTHER
WORN 0 BLD. 0 PLM,. 0 MECO. 0 M.N. 0 POOL
No. Be / No. Marla
CERTIFICATE
of EXEMPTION
Rooms re. 01 Dw.INner
ReaV. AGO 4. l
r0;c
I
•
�}r
SOUROE
ifai PQ UTILOITIE
Ernon. 010.
ocallon (A7al)
OAS ELSE (W EWER
Public 0 PrIwN Ip
USE CODE
I hereby certify that I have read and examined 11111 etlul e:.men doll have lead the "NI)
on reverse side, and kl,Uw the sane to be Ireand Il di ct Ali ui � .1sios of laws a oil "
type of work will be complied with sellethe� succi tI ll I�.�I cin c �.� Ihengidntele rd
to gore euthorlty to violate or cancel the ptoved()nt /t1 Ldl ee .1Jle or local law Teen,
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
OATE OFAPYI.ICAC DNL2-7'ZZ'IO__... SII. II .ell. .11,CANT
new,
wenn,' tInv
Ig.
SPECIAL APPROVALS
NAME DAT
SPECIAL CONDITIONS:
s�raita Pw,L s PFfwuz
- NlORK dI4MV
,C,21)2- zN — 3933)
FEES COLLECTED
SInel S
Building 38�
Plumbing
M.Ch.
Plan Chalk
'100A—
Mobile Norm
EV d
Other (Speedy) 3S
IMPiOrfr
TOTAL
.74t00
•7600 0
6474
WHEN MACHINE VALIDATED IN THIS SPACE
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