1979, 12-31 Permit: 79-9572 InspectINSPECTION RECORD
OWNER
LOCATION
CONTRACTOR
NSE W
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
DATE REMARKS:
I�-31•"X1- [Yr,G • c.(�elet n[ (- �rr� t (D' edl w
CieAr uuk W ( 4dc M of Iron% -fit 561049; cat .&
11 - �O Gh(� ��� NIA J f �"
�d6 e ( &107/ -1(A. -6.1-11‘4.t- sruuP4
w
J
IPLAIY NU:MBER
TION/PERMIT
ARTMENT
N 811 JEFFERSON / SRO., , 5091 056-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ARDRESS
LOT BLOCK SURD,/
LEGAL DESCRIPTION — SEE ATTACHED
-N00
00-7 Loril goA
33r7
PARCEL NUMBER'S
Repulreci Set Backs in Feet
North 50055East Lest
PHONE
5)56 5) Parcel Zone Classification
ZIP
Type Const.
SorInkieree
00es Elho 03653.
OESIGNER
5' ADDRESS
ValluatIon Bonding Pr. In 55.73.
ZIP
6,66!33653 03661 Garage Area
CHANGE OF USE FROM
8.
TO
SRA Entry
SRI, Level
TYPE0 er.,Ew
7. OF
WORK FLD
0 ALT. 0 ADIN.
PLNIB. P"INECH,
Doso ""E.OTHER
111 M.H. 0 POOL
No. Baths
50. 710039 iNo. Rooms
Rec. Roorn
CERTIFICATE eoid. Reed.
of EXEMPTION
Not Rec..
e. 4 Ni& -Au
VALUATION SYT. GAS ELECTRIC
Uti7ItAS
I hereby 51.1 11)5 that I have lead and exant000l 11100 appacatioi I sold hove lead the '701 O:L'' ovislons inducluLl
on ocooso side, and know the same to be hoe and co,rect. All provisions of laws and oolmooces governing 5,1
typo of work will he complied wall whether shecdool licteos or not. The gran tolg ot ooro,t .es not 010000013
to give authority to violate or cancel the otovisions any stato ot local law oscolato, construction or the
periosmance oi corltruc•ilon.
SltrIVATI
SPECIAL APPROVALS
Eny. Health
Planning
Fire Marsnall
Zoni,Solarance
SERA Checklist
SPE L CONDITIONS:
/
-e2
j2/ jdt
FEES COLLECTED
S gle $
Building
Plumbing
Nlech.
Plan Check
SEPA
Mobile Horne
Otho iSpec.bd
TOTAL $
DATE
04. .7.00
•700
9571
12-28-79
2 6479
WHEN MACHINE VA01,111- IN IHIS SPA,.
111,13 Whet,: A r • iM111,
2 g 957.2