1982, 05-03 Permit: 80-6634 InspectINSPECTION RECORD
OWNER LOCATION
CONTRACTOR
NS E W
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
DATE REMARKS:
j. Z-7/7 .4".1-7 7C)
�j>
APPLICANT: COMPLETE NUMBERED SPACES - PPFSS I4ARD TO MAKE 3 COPIES
JOB ADDRESS
1. 5, /11,3 Wo to
su 1 o
LOTALMA
.2. / 1. 2 Sotairwcoo rel•eaS r
a c.X7,11 0111.6 -
ADDRESS
, "YE'S ap.es'A,A0.0
LEGAL DESCRIPTION - SEE ATTACHED
PHONE
Vas
ZIP
9/ ZnC
PARCEL NUNIBER/S
205,13-/Zo I
atm set BIC. F•II
1,101.111 /Z 'south I set /7 1West
50
CONTRACTOR
7-MMIe ?GM,
PHONE
44.V-VISCA•
ADDRESS
dir Z/V
ZIP
tarvese
size of Parcel
1615Jr/Z
-ryes const. r OttuP•ncl/
Zon• ciesumation
S/AgaLsg r/PoOtost y
Sprinkler,.
DV. Duo El AMA.
6.
DESIGNER
PHONE
YkRolon
oo
Bolidlno Area In So. Ft.
ADDRESS
ZIP
main p.m
upper Floors Germ. A,.
CHANEM OP USE PROM
•
Are. of Omits I Finish easement
UM.. MACRO.
Tv.' 0 NEW 0 ALT. 0 AD.N. 0 RPL 0 INVE.
7. oF
0 RLD. 0 VAR.. 0 MECH. DMA.
oEscRisle 0000
'Pool1:1 0,14ER
6.
Akff=r01:0
urlLlros
I hereby cerhfy that I have read and exemined this -ipoi,cah,,, Ar, r I r ' ,nclorl,q1
on reverse side, and know the same to be true aim ,t es governing this
type of work will be complied with whethei speed!, rrrr rr. rrr karrr, r,ot mesome
to give authority to violate or cancel the provisions fon. ,n,410 thr
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATIONfr-C' • A HIM -
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE
Ske/e,e/se.esey Asec
OAS
EL CTRIC
WATER
SEWER
SORE.P2W
No. Ba. I NO. Storift No. noonn 17. Of DM111.1$
CERTIFICATE
of EXEMPTION
1041,11. DIAL ISMAlloo (Are0
USE CODE
IcVd. 0.0 d. rof70.
5*. Engineer
0)00114*
51404 084
dp#04. -7b aso Tows rpm.
FEES COLLECTED
5.41
Road.°
Plumbing
Mech.
Plan Check
SEM
Mobile ROM
OZISpecIfy152-1SL-....
TOTAL 6 Zr.00
I 80- 6. 4P5V I
.2500,
.2506
•25005,
.11(A
4Y'1156,
117-02-50
6479.
(6