1981, 02-02 Permit: 80-7741 InspectINSPECTION RECORD
OWNER
LOCATION
CONTRACTOR
NSE W
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
REMARKS:
ION./PER
1 tt.ING C
MENT
s011t
1.
111 JEFF
PERMIT NUMBER
FD -77
APPLICANT: COMPLETE NUMBERE4,.6Pft6ES - PRESS HARD TO MAKE 3 COPIES
LEGAL DESCRIPTION - SEE ATTACHED
Lo„ Ao SL03o aLROLVIADN /1'V�LIA c /1j
°""...::."11"a'
� a��
a Ju
sur.-Ps'7p
21P
CONTIrS1[L0
OBSIONER
E' ADORE=!
OMMBE OF USE FROM
PARCEL NUMSVIS
S
North H Backs !South IWe
o1 P.lal Eo11. cuw11c.tlon
�7 0� aoNe
'M.I.
0,.s [No D Rs•d.
PHONE
7
Tyle Const.
VHatlon 191.11003 Area In 50. Ft.
IT0
Blain Floor
Ou• .90e
.900 K
.9006
E •000 8
77401
07-28-80
6479
aa.
UMW 900,. r ON. Ara 1 Stw.M
TVK ❑ NEW 0 ALT. AWN. 0 RN—
). or
0
no. 0 FI
.AIX1RyB. Ai SCH.
0 M
N.
Obctiet woRLrro t4_fiElC\iiCT4`,VALUATION UR
UTILITIES
a
0 PAVE.
0 POOL
0 001135
Ara o1 O.0,. I Plnlstsa .anent
No. Baths . I No. Biala 7I No. Roos No. of 000110.s
R aiL. rot RoE4.
CERTIFICATE
of EXEMPTION
Gnats. OFR.
Rep'd.
Ural. Romero
FEES COLLECTED
WATER
SEWER
o. .oIp I MS coot
P0.11c DlrNate O
1 herein certify that 1 have read end easmiriod this application and have read the "NOTICE" provisions included
an !Merle side. and know the ams 10 be true and correct. All provisions of laws and ordinances governing this
Moe of work will be complied with whether. !pacified herein or not. The granting of a permit does not presume
t0 give authority to violate or ,tical the proem ions of any 011te1 Stole or local law regulating eonetnlCtion or the
performance of conrtftwtlon. BEE REVERSE BIDE FOR REQUIRED INSPEC
DATE OF APPLICATION 1-- 20 EIONA HAIL W AFI'I!CAN
�E0K APPROVALS SPECIAL CONDITI0IMI
NAME owJ /
n FOR CAS APPLIANCES
Enr. H.ei1R /
Ti.
nnlns
Fire Martha!!
Co. Eisele..
PIPE SIZES
PIPE LENGTHS
BTUS
11 .nr lR"
SI031
auiltl�ne
Plumbin
Plan amok
SEPA
Mobil N
Otte ISpacIvl-
TOTAL fC44::13
0110N MAlIlINr hili ln0Irn ir. n11100001