1982, 04-12 Permit: 80-7308 InspectINSPECTION RECORD
OWNER
LOCATION
CONTRACTOR
NSE W
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
DATE
fA2
REMARKS:
3
• APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOADDRESS
�_ S / lu ,
LEGAL DESCRIPTION — SEE ATTACHED
LOT •LOCA SUBDIVISION
JC7 7 7Torce/Fwe,O Ac e- PieFCrs
PARCEL NUMGER/S
2454/3-0 ?ea
OWNER
3, n* l'Er 5C477-
PHONE
922-149 z
ADDRESS
S. /301 LI/AECrGr
211,
94037
Actual set Back. In Feet
North Isoun— East a Iwed
CONTRACTOR
*4%9.4400,4/i. ..
PHONE
SIG or Parcel ole Clesslflution
/4/E. k$BO Ifl'iat. ASAY
ADDRESS REBS
S'j t
ZIP
d
Tr Coml. 11 wncr swtniow.
rao Roo
Oyes ONo ❑ Roc'o.
a.
DESIGNER
PHONE
...Dion OO Bu1M1�6Ar.. In So. Ft.
'Pea,.
G ADDRESS
ZIP
Floor Upper Floors Garage Area Storage
CHANGE OP USE FROM TO
�.'
Area of Oecke Pin/10V EaNnwnt
I Untie. Sommers(
,n ✓
T Of ,if New O ALT. 0 ACM. 0 RPL O PAVE. O OTHER
‘0,...'
Or— _LO' 0...„.G' O M5CH. O M.M. O POOL
-
No. Baths No, Stories No. Rooms ro. of Dwellings
CERTIFICATE Rare. Rec d. rIct Rao'd
a/ EXEMPTION I ✓
G�GCRI06 WORN- 11
`. VAAUASN 7URCE r 6/1.1 7 T^r7 IN ,BeISalr6, 7
Crum, DIA, Location (Arm
fEEBCOLLECTEO
Singles S
0jVALUATION SOURCE GAS ELECTRIC WATER SEWER
ELECTRIC
a 600 UTILITIES SEAT.0
Owner..USE CODE
Public CIPrIvate
I INeeby;BartIty that I have read and examined this application and have mad the "NOTICE" provisions included
On Matta skis, end know the same to be true end correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPE TION
tulldinp 46//. 5D
Plumbing
DATE OP APPLICATION 11 f Pt' SIGNATURE OF APPLICANT
fin.
EFfCIAL APPROV
vs NAME DATE
SPECIAL CONDITIONS:
1
Plan Check
SEPA
Plarvlieg
Mobile Hons.
Pke Newhall
Ce; EaRrNer
Other (Specify)
ill
TOTAL 8/I'5.0