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Date / P - :2 (J - 7 ~
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CITY OF OSHKOSH HEATING PERMIT
APPLICATION AND RECORD
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Application N? 3561
Owner
Address
Building Use
Type of Heating System:
Forced Air (number)
Steam (number)
Unit heater (number)
New heating system
Conversion Burner
New Used
Calculated .Heat loss ;; r., tJ .~ 2? ~~ 0 {!~~.
Size of Umt(s) ? 2~~CJ ~ TCL C~_?~.R-C"-'
Miscellaneous Work to Heating System
Type of Fuel:
Gas
Coal
Other
LP
Oil
Electric
:::2.-
Hot Water (number)
Gravity (number)
x
.
Replacement of:
Heating Contractor
Add ress
Valuation of Work
Electrical Contractor
~C"-
0. tJ 0
,
r-66
Fee -.:::> ,
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)
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Address
Heating Inspector
Final Inspection
Owner
Agent
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