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;',�.E�°,"��.� CONSTRUCTION <br />CIT'( OF �\� <br />ederett PERMIT <br />CITY HALL2598145 <br />eveaerr,wn �azoi COMBINATION • BUILDING • MECHANICAL • PLUMBING <br />Aron <br />Jorgensen Sheetmetal <br />❑ COMBINATION <br />❑ 6VILDING � PLUMOING [�1.+ECHANICAL <br />A <br />L01 BLOCK— <br />JOO ADDRE:IS <br />?32 <br />PI.UMBING <br />252-4690 <br />❑NEW ❑AODITION ❑ALTERATION ❑qEPAIR <br />❑OEMOLI51i ❑FENCE ❑SIGN ❑SWIMMING POOL <br />OR ATT <br />T[R SEHVICE SIZE BLDG. SUPPLV SIZE <br />�EYAPDSETOACK STREETSGTDACK REARVARDS@TIIACk <br />SPECIAL CON�ITIONS: <br />❑VES ❑NO <br />MECHANICAL <br />TVPE OF ENEHGV <br />❑GAS <br />NO. _ — TypE OF EOUIPMEN7 <br />AIR CONO. UMTS-H.P. EA. <br />REFRIGERATION UNIT.'a -H,p, EA. <br />OOILERS H.P. GA. <br />FORCEU Alfl SVSTEMS-d.' <br />SVACE & WALL HEATERS - <br />uNir iienrEas- n.r.�. <br />G V AVO fiAT I V E COOI.E FS <br />c�onies ur�ver.s <br />VENTIL/1TION P nN <br />RANGE HOf�D <br />AIN HANDLING UNIT- <br />WATER HEATER <br />fAC. UUILT FIREPLACE b 1 <br />GAS. SVSTEM: NO OP OUT <br />C.F.M. <br />NEY <br />twcrett <br />1249-7'T� <br />c� <br />o� <br />-v� <br />_ PERMIT 5 � �� <br />TOTAL FEE S '� i QQ <br />i111S PERMIT OECOfAES NULL ANO VOID IF WpHK ON CONSTRUC <br />TION AVTHORI2ED IS NOT COMMENCED WITHIN 12D DAVS, OR IF <br />CONSTRUCTION Ofl WOIiK IS SUSP[NDED OR AOANOONED FOR A <br />PERIOU OP 120 DAVII AT ANV TIMG AFTEfi WORK IS COMMENCED. <br />I IiER[(1V CERTIFV THl1T I HAVE REAU A1JD E<AhllNfU THIS AP- <br />PLICATION ANO KNOW iHG iAM@ TO [I[ TRU[ AND COfifiCCT. AL� <br />f9iOVI510N5 OF LAWS AN� OfiDINANf'[5 GOVERPIING THIS l'VPG <br />OF WORI: WILL PS CONFI.JEU WITH WN[TNI:R SPkCIFI[O HEfiEIN <br />OR NOT, THE GRANTWC OP A PERPdli DOF.; NOT PHESUME TO <br />GIVG l�JT:IORII-V TO VIOLATE OR CANCfL THE PROVISIONS OF <br />ANV UTHER STATE OR LOCAI LAW R[GVLATINGCONSiliUCTION <br />OR THE PLRF6RN,9NCF OF CONSTRUCTION. <br />NUMOER <br />FEES <br />FEE <br />8/16/77 <br />.AGENT DATF <br />PLAN CHECK FEG <br />RECEIPT NO. <br />VALUATION FEE <br />G� <br />DCC. LOAD 6UILDING $ � <br />PLUMOING I <br />�EOKLERS �_ <br />ES ❑NO MEGiANICAI % 1 00 <br />OTIIER � <br />—__ � <br />PENALTV S[C.30JIa) I <br />TOTAL % j OO <br />f'tCF:7!TVALi1JAT10N - <br />l+'HEN 1'qOPEh�y \'Pt IOM E1� IIN j�1���CE) �'(��P�•�••IT� <br />7 �� �rR <br />-- Y06fR RECEIPT, <br />°�°°�:���^���°� THANK YOV=�� <br />E.B. . <br />� - . <br />' _ . . �_R /�:,�� :. <br />