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1982, 09-24 Permit: 80-7755 InspectINSPECTION RECORD r - r3 OWNER LOCATION CONTRACTOR N S E SET BACKS TYPE OF WORK/ FINAL INSPECTION. -� DATE REMARKS: IPLA @NUMBER APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES JOB ADDRESS 1. LOT 2. OWNER mCS OVA ler BLOCK S- �8 N Mc gr' DIVISION /9s-- • LEGAL DESCRIPTION - SEE ATTACHED 3 ADDRESS CONTRACT 4• ADORw_.. DESIGNER ADDRESS =2"` 4a- X499 X90/6 PHONE P ARCEL NUMBERS 1 ?- ZIP Actual sat se of Perm a 19uut�"` Zeno CLNlllo loo t Type Const.Sprinutered ❑Ven 0No0 Ran,. Valuation Building Area In Sy. Ft. Main Floor Upper Floors era" Area Storage CHANGE OF USE FROM a TO Arw of Owks I Finished Basement Uniln. Sanment TVP[ 0 NEW 0 ALT. AD'N. 0 RPL 0 MVE. 7. OF RK 0 BLD. 0 PLM.. BCH. 0 M.H. 0 POOL 0 OTHER No. Stories No. Rooms No. of °wantons 1.1 CERTIFICATE Rased.of EXEMPTION Roc el. rot Renp. DESCRIER WORK 8 EOM". Dish Logsdon (Arent VALUATION B. SOURCE OAS UTILITIES EI.€CJTrHIC WATER SEWER Ownership 00010 O Private 0 USE CODE I hereby certify that I have read and aaned this application and have lead the "NOTICE" provisions included on verse side, and know the same to be true and correct. All provrsn,ns of laws and ordinances governing this type of work will be complied with whether specified herein or t. The granting of a permit does not presume to give authority to violate Or cancel the provisions of any other siiitp or local law regulating construction or the perforntarwe of construction. SEE' REVERSE SIDE FOR REQUIRED INSPEC(J`(�nJS^ DATE OF APPLICATION 2-0),5--20 SIGNATURE Or nra LlcANr WC; r` -t9 F Ct yK'ti FEES COLLECTED 01 g1 $ building Plumbing Mach. SPECIAL APPROVALS NAME DATE nv. roar Planning TWO Marinnl Zo. RIMMED Utll lflwki '9laos Examines SPECIAL CONDITIONS: FOR GAS APPLIANCES PIPE SIZES PIPE LENGTH-'� BILIS Oxy PW Chock 144�% $EPA Mobilo Roma Other ISpwlfy) TOTAL $ q'CX3 PER MIT NUMBER Y�- �zsS, 04• •9.00 .900 B .9.000 •000 S 775546 07-28-80 y 6479.