1980, 07-16 Permit: 80-5150 Inspect'►
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
N S E W FINAL INSPECTION:
SET BACKS
DATE REMARKS: FQ 11ND4t't'/( v ' lye _sr?,
,I,6?
,86 .V7a444,t eitren/
9• /-t'v Dr ga// 'fr .
q_z3-� .,. ./d.' 6v 7 ,` ,// /ciao°
, y , -0,4"
1
�NHl1Mt•[Y :11 `', 4 1 Yy1'I 'l a S -II vR-trLY 7tl rPEAMITNVMd[N ��
.2?r 736 I 9`' y ,e,r I go_stsc
•
APPLICAN . -- - l • S—PRESS HARD TO MAKE 3 COPIES _
JOB ADDRESS LEGAL DESCRIPTION—SEE ATTACHED 02. •2 Off 00
I. ars/♦ /STN
LOC 150cR SUBDIVISION PARCEL •NUMBER/4 •204:00 6
2. tN Jr R 0 Ktiita6..,,-y F4./V[e- 4Ariue.raasr plovers E:u dtKJ9�1' I Z
y�yP •2•00 00tl
3 V'J a..(BE-900V 2o5Vv-5/r9'o 0 '000 0
ADDRESS ZIP Aetu.l 5.1 Back.I..F..t 5 1 0.9 f
COIUTA9ETOR 7(3 Sig - 9?e't No m E'S' (South//O r zst S' IW..I 9' _
nuONE P..F.I ,...c*. �.al.., 05-30d`60
S .a
. ADDRESS SIP 5Tv 6VA"Ar r*:o....v Alive S4SmInkPekA/ S 6471Q ....:+•i!
�>,, Ores Ono 0 Redid.
veteran. PHONE VEIUMIon (Oy Building Arm In Cc.FL
5. .t 6Xy '
' ADBnaw ZIP Men Floor UM.,Moen Ceram Area I Ster...
IHANO[LOF U.e FROM ITo Z lItvt Ream I Finished lament I .�7rru nn uRm.nt
Is W NEW O ALT. 0 ALFA. 0 RPL, ❑PAVE.
N .lhr I N�Mena NoJAPam. of Dwaine.
T• OF 0 OTHER /
y.DRtg CI BLD. O ALMS. 0 MECH. 0 M.H. 0 POOL CERTIFICATE Rapid. I R.cy r.Reed.
Of EXEMPTION
DEEBAIEE worm Eeum.Dish Dation LArml
y1 SEM/tt FjC.RCE R�/pR.tATELECTRIC
FE[9 COLLECTED
til/#1/9'.."1;fij
,r 'e.assFll IEFC .W.R. wAT[A sEw.7,E. Own.nmp WB CODE
D.vie.ass ununey W.W.P. .SA'7ic Pullin❑wlmt.}Y Bingle S
I hereby certify that I have read and examined this epplicauOn and have n-ad the"NO 1 ILLIn urisions included
reverseon JII 11 11 5 knOW file Salim In tit'true and LL knit.All V brie[of law.:Ind,ii rho .ret governing th.•
NCB Of Werk will be eompl,od with whe Mr... c,hed herein. V The gra does not Pre Rui101ne /a oo
to give authority t violate or cel the u other s cel mai.,
,ii ,,nstruch0n usuthe
performance of construction.SEE REVERSE SIDE FORREQUIREDINSPECTIO wS Plumbing
DATE DE APPL ion TI ON 9- -7o LIlNATURt IIP API- i FV �
*MEIN.ARNGVAN EGIAE CONDIT NB: 1
NAME DATE / ,) v(/J,,/ O/ OI.n CI...k
-is.•••• • L v�tfeg�illCL ye r' /ll�/Ls•7L `Ft 1 I�
/ / (/,J SEPA
_'/ :/I I'IFPrIs�rfA9itil' "DT=ft"'-,PIE)
Omer Iwrnm
Illllil ln �/f Qy �. _.-..___—T
TOTAL E1O/