1982, 05-11 Permit: 80-4696 Inspect r„� v
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSE W FINAL INSPECTION:
SET BACKS
DATE REMARKS:
/` i �e
11
(PLAN NUMBED I I...--�"-- .
-ICA PERMIT N
CODESD= ` ; „ 4G9G
cTDry D.E.!, .4
APPLICANT: COMPLETE NUMBERED SPACES PRESS HARD TO MAKE 3 COPIES °
JOB ADDRESS ••
I ` s��� LEGAL DESCRIPTION-SEE ATTACHED •22 0 8
2. S� Q 'SA/31610N
EZ ran.au t T V l>ISioA.a4g ZT PARCEL nUMBER/3
OWNER PHONE •22008
3.
ADDRESS
�*AY.ISLEY 'NLA-S'IOG Zls.42-C.A40 • •000 8 .
S. 1G,r5 �/FXeL.g ZIP Actual Set Backs In FM IWe a 69. ?
CONTRACTOR 2 GRZ\L norm Isopm
l A1�2T71SIPC Bcel�p lr� PHONE s1..of Pa._ zo 1.cl.Mmuuon'[ 0`+-13-80
DOREss 5 4K3b4•NF
g� P.J. Type Corot. I occupancy Sprinkler.
6479.
DESIGNER
MA2K zp7
ate.. aNf 0
PHONE
lue Building Arfa In SB.Ft.
5.
ADDRESS 21P m11n3Flopr Uopar FIoaN -----
.
I Slorepe
CHANGE Of USE FROM ITO a'I tlec 1 I FnHMd Ammon.ye
8, Arf fmon.I ill.Emmen.
❑NEW ❑ALT. 0 AWN. O PPL. O MVL No.eater I No,Soul.. No.Room. INo.of Dwelling.
T. WORN Cl BLD. 0 Pam.. 0 OTHER 0 MECH. ❑M.H. ❑POOL CERTIFICATE R.q.d. qec a. rotq.qd.
9cRIBE woRX or EXEMPTION V
„, [um.DM. LputIon(Arm
,
FEES COLLECTED Rew.In �pyq 'Rear
¢ eHALugiloN sOURCEI oqs ELECTRIC SEWER OwrMlc USE CODE9 `3 IUTO;IESI I Public OPIT..
Single S
IYPo 1 A
to give elllhOrlr; I Iv II ..., „iI of Ing Building 27.'()
laT
fiSt
D*ry nelceliI AI...union
.gE/pk^E CONDITIONS: HtI)UI IFI 5,.��j...
S � SID IrJN/�/ ///j��/fff Plumbing
DA rt Of APPLICA I ION J Q . �/./�97%/_-,.
SPECIAL NAME APPROVALS I SPECIAL
AM[ DATE
Nen Check
r n..r.nui -1
/ f�_ SEPA
'p Mobile Home
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