1980, 01-11 Permit: 79-9384 Inspect INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF W RK
N S E W FINAL INSPECTION:
SET BACKS
DATE REMARKS:
l - If' 8b `4k4 5rage7
r
"A'"u
"Ep` APPLICATION/PERMIT PERMIT NUMEER,
/ TMENT77 �" _
_ -- MG OATS a,.. -
•
APPLICANT: COMPLETE NUMBERED CES-PRESS HARD TOMAKE 4 COPIES 02* x9350
1 7A ri7- - ramd6P PA LEGAL DESCRIPTION-SEE ATTACHED .9350 k • ,
bf� p Sio U 's •93500
2' 3 R�DL pi l�`-,Anon ori PARCEL NUMBER'S PI r27
3. 71
la, rKAMIN6I u O. :M-31 S4- p, I e .000 8
oo�� 9O eO o"m'2 r else i:••f .„
40 p s0 93832
or•OS �K I AU AA y� 12-20'79
p%��M 5'VX' 121-. z'FIWG.t��� 8 6479.
4' ADDRESS ZIPr• sPrinklarw •
T V Nen. o3a> Dv.. oNa ❑R.ae.
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DESIGNER PHONE Vdtwlien BullElnezO''' ...-• •'
6, ADDRESS =IP �� HBe •
Arm .5 e 1 tamm —
CHANGE OF USE FROM TO SPIT" I Entry i,LweR.R
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IN NEw ❑ALT. ❑ADN, 0 RPL. 0 MEE. ❑ ryo;ms o, ma R
0000
ME
7, ogq �LO. 0 PLM 0 MEEK 0 M.1-1, 0 FOOL OTHER CERTIFICATE Reg a. Ree 0. 11,101 Reg,
of EXEMPTION
pq FEES COLLECTED
V`, r � � '�v
� GAS [L[CT91C L�/gfTIC 1RI�py,I1� �/I�4�l��w�PeR
0, V fD JIO000 Utli 1H �L// �1"-.'`'"'�^� '•' SITEle f _
I hereby certify that I have read and examined this application and have lead the'•NOTILL"provisions'included ny.I9
on reverseside,and know the same to bel true and collect.All provisions of laws and iiillhl.mces governing this Building 70
type oork will be complied with whether specified herein or nor.'The granting of a perind does not presume
to give authority to violate or cancel the provisions of any other stale or local law regulaling construction or the Plumbing
performance of construction. "'•{'•L ,`r f
SICNATU rl n,44`• \, \•'- °
Mwh,
DATE a
SPECIAL APPROVALS SPECIAL CONDITIONS: Plan Check
pE0'D. REVD. /
Enu�Nulln �l[A n �Pi�./r�f „/I,., /.e/ .C.�viPd .
//�,'6&4 7////7I J SEPA
Mobile Home •
Fir
Ce,Enelnwlr Other r ISpwirvl r
utlllnea TOTAL f
Zane Clearance • WHEN MACHINE VALIp TIED IN tN159PACE, r
E TM IS GtCOMES A Pr
SEPA lst I''_4R<o9. �./� 1. d:'r I ••12'-12 a—`A9M 9)8.4T a,
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