1983, 01-31 Permit: 82A-8591 Inspect •
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
N S E W FINAL INSPECTION:
SET BACKS
DATE
:13KSc : 1411
yede
•
APPLICATIQN/PLRMIT "'^"M■Ep � f
t SrcKANG GOi nrr—UUI INa cOQC DEPARTMENT 3 `ems -8:f1I ►t"'
DAIEN all uf11114011 1 1•8111.11.Ne1NIN\TON am 1 111111/YL11
ARYLICANT:COMPLETE NVMBEA€8$A0€$-an CO HAM!,T8 MARE 40801F,$
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• .ea SARBEEE/E�I //�� Ft nJ LECAL DEECILIYTIDRI-EEE ATTACHED
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1 AMTUA I'Ila 31600
�o«N i. .Liu IEC n� '11 -PCf31' .1600G
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_Jn eI LC'• 1�" O_L_EA. ':...., 1.3." �b 6500.
;3 I ' •• .447: -25-82
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\•1 • A ' N.erwe ry Va... ••. �V••M Fulalm Arm M Sae FL P 6079
DESINNE1
L' ADORES& fIO MEM TIM use*Floors Perm Arm I SWIM
..../,.1.OP VEE PAOR TO A._et Meer. 1 PHM..E._O..i I V......m... '
\ TVPE Cu... O AL,. ❑AWN. ti 0 Mee. O OTHER we.e.n.. ....sl. »m. IN...a«I..e. •
{ '' 0µp 0 PLAN. 0 MECH. 0.1.1 0 Pool Cf RTIFIGTf M .Il.n 1. pu C. ►bl Py'o.
WORK w EXEMPTION
. WORK
5jy
ALL'
wowK CE (t 1-1-+I
?I I lE n r"� SEwE• G N E KL IL KCeC eel FE ES COLLECTED
11 ELECTRIC 111
�UTZTIES .i o r MIE OwHn.O , FrNN f
1 Nutt,'certify.Nl 1 hew.reed end.oeponed till acplica on and nave reed the"NOTICE"provision.Included
\n rev. tide.and YdN.aroe to be true and MANCE All provisions of laws and ordinances governing this WIMYIa
PPO.ofr IN.
work MP b complied swell wnedwr specified herein or not The granting of a permit does not pr.sonse
as give authority to violate or cancel the provisions of inn other or local law re•Ileting constnlction or the
perrormanov of cpMro ttiort SEEEREVERSE SIDE FOR REQUIRED INSPECTIONS/ �/� Wwmlw.N •`
born OF EPPI ICATlOIt A e 16,.A� SIGNATURE OF APPLICANT L)UJV a LIl UI'Yl'1 Owl,. \
SPECIAL APPROVALS SPECIAL CONDITIONS 1 Nee...Ka.. et,.. name GATE V`1l :
�0 � SEPA
LOCt±Clt.) aL1JYlki, $
"• •„
OMR.IipMHvl I•
uuum.. I,r.nd`LAV E e,v I�O1° jA..\ETOTAL E IIrQ.�
W WHEN MACHINE VALIDATED IN THIS SPACE.
THIS BECOMES A PERMIT.
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