1981, 12-16 Permit: 80-5200 Inspect INSPECTION RECORD
OWNER
LOCATION
CONTRACTOR TYPE OF WORK
N S E W FINAL INSPECTION:
SET BACKS - -----_- -
DATE REMARKS:
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/;% e r e r .. 4`
4
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PLAN NUMBER .ate r.e. • `1 9;.E renmlr nuniRER
`
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APPLICANT COMPLETE NUMBERED SPACES
PRATTRRE55 nRD TO MAKE 3 COPIES
JOE ADORES 06'• •8000
1. e. t21o4 2c.",. LEGAL DESCRIPTION-SEE ATTACHED
LOT ewLR aunmxlsrora
PARCEL NUMBER'S •8000 6
2. "7 IG SI:'1 VIEW PyLIO &Ids ITtoN I •80008
OWNER PHONE
s AF.Rrss GAL.," 924-s.1SI ZA5g4-FO07 E 0000 8
E.INto4 240't 44zx nate a4•n•uIse..6z' art az IW.R 10'ZIP
505 a
CONTRACTOR PHONE Zona Classification 05-28.80
4. Boa TVAua Rn") 3LI.cot.rc 4to6-4tz8 sac or 90 x I O Aaetc. SIATtiuRLNNN 4 6479.
ADDAMS ZIP TYwC t O SeonatWN
QT y -ear,* APES 1JINt MN_e 990,4. Cana. .Pun. UV. Ono 00.00.
8' wROISOERDOSISSS PHONE .4 riO* so4 Building aArm 96'n 50.Cl.l
ZIP Main Floor UPPM Floors Garage Area r Storage _
A Awe --- _. I _
CHANCE OP USE PROM TO of Clacks I PIMP.. • ownt I
a unnn., meet
.»
TYPE I�HEw ALT. ❑oo•n. ❑RPL. 0 M n.Aetna I Nos no.1Reems INP.of awallInas
7. ypin vE. 0 OTHIR — — I
Rn VI PLD. 0 PLM,, 0 MEC». 0 M.n. 0 POOL PClRTIPICATE foras -ROC'[. Rae C, RNII.
M EXEMPTION I 0'
�MACR1IEE WORK [num.out. Ron(Ansel
` vgLp.Afl "Eta awl tCeyC6^FAso w�AT I�Doh REED COLLECTED
UOURCEfE I ELtCTAIC SEWER Own. US.COOS
9.q.504." SCTTIt P0011*CI Private reSingle 8
I hereby certify 1111 I have read and n.annnod III.opnli L.alloy and I,iv. eyd the"NOI I.r"r,11,VJSIOnS included
on reeves side,and know thea a to be true awl clot.All provisions of laws and ...I n ea governing this -
155l of work will be complied with setwoter speeltied halenl OIrioty Tire granting of,i n Iloes not Ilse me Eu1lCing B(7.OU
to Elan euthorlty to violate Hi tont&the Pravorone of any I Ihnl smlu or local low nwll, .I ittIll two to
perrmmanae of construction,SEE REVERSE SIDE FOR REQUIRED INSPECTION � PIUIRhap
DATE Of APPLICATION .Ot sn SIGNATURE Or APPCI Nggh. .1
SPECIAL APPROVALS MEDIAL CONDITION,:
Eny IR NAMEATS AA Pin Chant
�� n V Ai AI,. -rt. 'CO..T't•Ac70 a>, REPS •
Fire M111arshall 7 Pei Po r+C RWK Mi es 'il
/ MotIIa Hama
O //'
/ ,, ''''r
Other 1BositTl
N. / TOTAL SBO.�O .—T----a
TOM PPS :02,1-. LSI'EM WHEN MACHINE VALIDATED VI THIS SPACE.
,L THIS Rf COMES il PIRM11
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