1981, 03-31 Permit: 81A-2601 InspectINSPECTIM RECORD
ADDF�SS
DATE
��r
�,Py df2ojQ/ SPOIfMS (Pk B`1ilf 1 ! TMENT
f�M ORTH ail EFkE RbsON / b N w
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
D Ess LEGAL DESCRIPTION — SEE ATTACHED 02- • 1 79.0,0
.179.00
21 2 10 q,�b�� R�eL NUMeERh 23531 _ 1001 •179.010. .
NER Gimes
1 _ •000 8
woDREss o� + efc.. 2600Y
coN�TaAT al I� DNE `^als� mF - /0' L.
020-&1„
-L lm X210^ b'E�
S-1 a 3A 4 7 K�,,A,
Oc u
qDD Eae
-77 1 i❑Ra
D[aIONER oNE Lr( J avj V eunelne ArM In Sg. Ela
B
ADDRESS
2e1a000 20 ��
P smr,w
CHANGE OF USE FROM ITI O m,n
TYK NlW 0 ALT. 0 A—. 0 RFL 0-
7.
MVE.7.OFVRO. O e10. ❑ RMe� 0 MEC.. ❑ M.H. 0 POOL 0 OTHER CERTIFICgTE w a
.& r,......... .. .... �...:.. .. ... �..:�n s..,r
FEES COLLECTED
eingl. E
'.
(/7i
i I I/
\,y7 1../�
A ON SOURCE GA] ELECTRIC q Ep SE -.A Ownarahlp E CODE
p. LD Un IInEa COMM • � wlam ❑Friv.0
1 hereby certify the, I have read end examined this applicauoo and have read the "NO11('.F" I:�ovlsi inuludell
and know the to be true and All laws ili�.,,lces nl
I�7 �'
;off —am alde, a me correct. provisions o1 anal :r gov ling s
lyfse of work will be compiled with whether specified heroin o tat. The t'u,g of � : �t does not
eunding }_L�_
gran presume
to give authority to violate or cancel the provisions of any other stale or local law iegnilu�inl ...... uctiou oI the
performance of construction. SEE REVERSE SIDE FOR REOUIRED INSPECTIONS
Plumbing
I.t'1
P"
3`/ �'let
s),MATE OF APP LICATIONJ��— SIGNATURE OF APPLICAN �a'e- _ _
.-h.
Plan Check
{rte„
IAL AFMOVALS
NAME DATEApPJ.
eFI CIAL CONDITIOWi
'IF:01,;, Jc e, I N "(�i Y a d
t�I o. caMMpwVv
1
P
eEPA
t 3 13 FI
546 d Of Off IL e AaeA
Mono. Hom.
�P7
1465 4 of 60fArc 4 -3 RW
3 13
A,011.QD✓lo ",je-fS P!Rfo ✓AL r -ACA"
/1L/fr 0. YC 270?2
otn.r lepsdyl
il
27000E.
TOTAL If 27==,
--. - .1.
0