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• CITY OF OSHKOSH HEATIIVG PERMIT � /
APPLICATION AND RECORD �
�ate !. __ � ''` �- !' � appi�cat�o� No 3907 �
Owner f�:=�=!_`'__/}i-�---�--��-r`-ff�; �, � i� r'�!J � S i7 �� :� � r_ ;_j 1t ,.�
Address- -- i � i � i_ i f� �`� �'_i;'
Building Use =� r ;%�/c• � i:l �` �( %`i r � i i� J= .S:
Type of Fuel:
Gas Oil
Coal Electric
Other �_ l ,� ;, r;,.' �� ,r ;--
Type of Heating System:
Forced Air (number) Hot Water (number)
Steam (number) Gravity (number)
Unit heater (number)
New heating system Replacement ot:
Conversion Burner
New Used
Calculated Heat Loss
Size of Unit(s) _
Miscellaneous Work to Heating System _
Heating Contractor �- = 1+ '- ��'� = rt ; {- ,; t =- � _
Add ress " �"�ti!�= t-'_tT � ;, e, r.i 7-i2 p ��_ ��: ;'_
Valuation of Work 0 � . �" — �—FE�� � '�
Electrical Contractor
The undersigned hereby applies for a permit to do the work herein described, according
to the plans and specifications herewith filed, and hereby agrees that such work will be
done in accordance with said description, plans and specifications, and in compliance with
ordinances of the City of Oshkosh and the state building code of Wisconsin.
�, � � , � -
(Signed) - '' ` � ' � Owner
Address
(By) Agent
Address -
i i ` / ' ,
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� �.��. , `' n� — ; i �!` —�--
Heating Inspector - �f,
� Final Inspection