1980, 05-02 Permit: 80-3796 InspectINSPECTION RECORD
OWNER
LOCATION
CONTRACTOR TYPE OF WORK
NSE W
SET BACKS
FINAL INSPECTION:
DATE
C-1/ fit,775(4(6, t- TOsibLeA
s
/f/e4 •M4ii
ZIth
1-4
7 --
REMARKS:
Az RUMEER
lJOB
ADDRESS F� rcti'Frr�jt� Kl.lJ
LOT 10
/
2. -CPI eLD1R IIP� `.. Y
ER
3 owNs-rW V '91J11,�,,
ADDRESS �• 1-1.0 110J
ED"M E
4. ADDRESS
DESIGNER
6. ADDRESS
ZIP
PHONEmain l
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER'S 17553 I1o6c
A.t a Set R j npl eF-6 R Last�5
Snn Pays.
❑P. 0No ❑ Rag e.
00110ing ,aa 125, FI.
ZIP
oae
Upon, F100St Gomm 9tae
Stomps
CHANGE OF USE FROM
e.
TO
Arm of Docks
FinIMM Basement
V ntln.Rasarnant
0 NEW 0 ALT. E:fAD'N. 0 RPL.
woRN dLO. ❑ MAW ❑ MECH. ❑ M.H. ❑ PooL
MCP!. wo. � _ 1 CC X
& 3 y
VALU T URGE GAS'r'GN[LFCJ RICT R
E. DTI UTh ,IEE +Evl•
❑ RAVE. 0 OTNER
No. Baths il
1 No. Stone. No. Rooms INo. of OwNnngs
CERTIFICATE
of EXEMPTION
.R e. 1 Ree•E, rPvelm.e.
Location (Aral
narMl
P
Pu .bc O rlwla
USE CODE
I howl, \' than I havr (0,l, o .
type rpt 40W w(11 be c Inl)hrrl i..,
<t nem authntilY 10 v(01,119 i-
pmhtlmmwv ul c001100chtm_ SEE REVEIISE SIDE f-( 1 REL)uIH(t) t tt`CRrciIUN',
001[ 01 AlII I, (0N_0 /.V_I/ _ �.I.. .,h'•ft/"ri�rV .�Lfs'."� `�
SPECIAL AMROVALE ISP IC�L_C SNDITIONS:_ t / pc_ /L 00\
AME DATE fL/1�I•y �d I�AFfL�hfll hj J
- P N e1 WEN. -o 01/41\1110..
FEES COLLECTED
S' EI E
Building 32 •
Plumbing
Mech.
Pion Chock
SEPA
Mobile Home
Other (Specify(
TOTAL S
%6200
+6220 m
•62000
•00
00-22-80
6479