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CITY OF OSHKOSH HEATING PERMIT
APPLICATION AND RECORD
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Date
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Application
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3581
Owner
Address
Building Use
Type of Fuel:
Gas
Coal
Other
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Oil
Electric
New heating system
Conversion Burner
New Used
Calculated Heat Loss
Size of Unit(s) J~S'~) 8. r U.
Miscellaneous Work to Heating System
Type of Heating System:
Forced Air (number)
Steam (number)
Unit heater (number)
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Hot Water (number)
Gravity (number)
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Replacement of:
Heating Contractor c----~~ @--tf: ~
Address ~f- .:1 I c.-n}~~/. ~
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Valuation of Work / ~ () . Fee =< I
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 an~ state ~ code of Wisconsin.
(Signed)
Address ~ _~Jk- ;?d.
Owner
(By)
Address
Heating Inspector
Final Inspection
Agent
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