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HomeMy WebLinkAbout2766 ePE,RM IT . , , CITY QF BHEMERTONBLJILDING DiEP.A.HTMENT ,'PHON:E: 478-52,81 JOB ADDRESS 619 NCQNSTI'IUTI()N OW,NEB' ' .~' fmEMERTON 98~12, MAil ADDRESS ZIP,' AT1LRNE lAT;HROP CON'fHACTOR PO BOX 1046, BRJlJMERTON . 98112 MAIL ADDRESS' PHON'E' . S'Hf.F Cl'ass ,of work: 0 NEW Q ADDITION o AL1E.HATION o REPAIR ,PHONE 479-2~B6 LICENSE NO. . - .: ., [!] M~E,:C'HA'NICAL , D P'LU M:,B,t.NrG CHiI'M'NiEY.(No fee 'inJ9rmati6n only) . INSPECTION,: GtoUrldwork Gas Test. M"asorlary ,Urnes .. Unlined Wasted Vents W~ter " Factory Mfg T~pe B ;fyp e L, ',' Htg. RUffin Chimrl'ey, " ! Locatiorl: 'Intemal .Ou,tside Wali Stove or insert Refrig. No. TYP8of:'Equipment 'Fee No. " Type of Fix~'urll'or Item Fee STOVES Ga~~ 'Oil~ WoodL 9 00 " " , . ' "J. WATERCLOSH I("TOH~ET) FIREPLACEINS,ERT SATHTUEj - FURNAC;E 'Gas (~at._ ~PG.-'----'-,..) Oil~ , LAVATOIW(WASH 'B.A:SIN) , I Wood add orn ---'- Other~ EI'ecfric~....!;- SHOWER BTl:J . -KITCHEN SINK & OISP. Ii:', " " "T:ype: Up now..",----'- 'Dowiil f,low~ DISHWASHER , Morizonta'I~Wa'lI_ l!AUNDRY TRAY CONV,ERSION BURN~R:Gas~(Nat,_LP-----.--;-) '\', , , CLOTHES WASHER , 'Under 1 OO,OOO~ Over 1 OO,009~ . WATEiR HEATER, " Qi~ " I 'URINAL - UN'IT HEATERS, BTl:J~. Gas_ E'lec';~', DRINKING FOUNTAIN BOlilER Ga~ Oil--=--=- Electrit~ : FLOOR - SINK OR DRAIN Other",-----,--- HP~ .' 'SLOP SINK GAS SYSli,EM:Max.5 outlilt,Tbtall~, WATER PIPING &- TREATING EQUIP. J" , " : EVAPORA"tION COOlERS Roof,---- 'Wall~ WASTE INTERCI:I:'T:ER(Greas'e) " . ' VACUUM BI3EAKERS&BACKfLOW DEVICE iBrU~ " , AC 'I:l'NITElectfiic_ Gas Elec. Combo LAWN SPRINKLER SYSTEM ~ BTU_ , SWIMMING POOL - Pr.ivate 'Public .. " HEA",: PUMPSinglePackage_ Spli'L GHOUNDWORK : Add orn~ 'BIll Ton~ " SUMP 'MIXilNG OR iREHEAT-'BOX ", .1 CFM_ Bl'U_ ALTERATION ~ , AI-R HANDUNG 'UiNrr'CFM~ BT'tJ~ POST & BEAM " i"'ANS -ExhatlsL- Stlpply~ ;Sath~ . 'I RANG:E HOOO -Residerltial~ Com rn.--,---', '. PERMIT $ CLOJ,f;l,ES D:I'WER Res.~ Comrn._ J " TOTAl $ Incinerator , " .- NOTICE AL TE-RATION T,O DUCT SYS"tEM " .- < THIS PERMIT BECOMES NUll ~NbVOID IF WORK OR CONSTRUCTION AU'ThlOB- lH~ating/Coolirng~ 'ExhatlsL-...... '- IZED,IS NOT COMMENCElD WITHIN 120 DA YS;OR ,IF C'ONSTRUCTIOtll OR WORK IS TANKS Oil~ Gas~ Rroparne w/OK SUSPENDEDOR,ABANDONED FOR APERIOPOF'120 DAYS ATANY TIME AFTER frorn Fi~e'Dept._ Gallo;'5_ WORK IS, COMMENCED., , -REFRmERATION UN:IT I HEREBY CERTIFY THAT I HAVE",READAND ExAM'INED~hI!S APPLICATION AND KNOW THE SAME TO BE,TRUE AN[j'CD~RECT. ALL PROVISIONS OF LAWS ANI') " " ORDINANCES GOVERNING THIS TYP8'OFWORK WIU BE COMPtlED,WITH WHE- .- PEHMIT $ " 1n I ('If) . , ' -", -' ~l'~ , THER SPECIFIEDHERE;IN O!,!NOL,THE GRANTING'OF A PEF!MIT DOES NOT PRE- , ' "TOTAL FEE$ " q I ()() SUME TO GIVE AuiHORITYTO'VIOLATF OR CANCEL THE PBOVISIONS OF ANY " FINAL API?ROVAL" :(S:E E OTHE R 5:1 DE) REGEl PT NO. (White,ORIGiINAk, Yellow,INSPECTOR, Pink:APPLlCAN.T)" \ t' ~ ". - , ~, '.'~._ ;... ~,. .']1 ~ QTHER STATE OR WCAl LAW R!=GULATING CONSJRUCT-ION OR JHE PEHFOR- MANCE OF CONSTRUCTION. No, - , I J r. '. ~