HomeMy WebLinkAbout0002868-HVAC (boiler)
~
CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
02868
TYPE: BLDG D HTG ~ ELEC D PLBG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
ADDRESS
l-/.3 j If, 7 h ft-v e-
5'T Pe !6z,:5' e/1u Y' C /J
PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
rSbplace OJcp//e 1/1
chure!')
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
.~
HE1TING CONTRACTOR &:C-. rf~ f/' f' / 'II (' & .
Heat ~ AlC D' Vent D Fuel/System IV' 0; Heat
Loss #S 1P~J ecf BTU'S tf BOf/er5"
. 71/112/ o.! ,,"'0 H..fl
ELECTRIC CONTRACTOR
Electric Servo New D Change D Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
FEES, Valuation t/!i'j~. dV
ISSUED BY _
Permit Fee Paid $
Date
/
.; hev--& ../
::;; ';J- / i' 7
/
Park Dedication $
Final/O.P. :J ~ ) D .-~ 7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~/~ ~:c: ~,Fle/2J)uo
c;? AGENT/OWNER
/J-);~/t?7
DAfE
ADDRESS
TELEPHONE #
PERMIT No.roP-8tpg' APPL. DATE l?/;--f/r?
ADDRESS ij !j CJ JJ/r h JJt-e-
OWNE~ 71cy t~j--er5' ch (Jr'ch
NATURE OF WORK R~/f/ce (Jo/ leI?
HEATING CONTRACTOR J7: C ~ H ~ r j/I; 1/ C (!J .
FUEL: & OIL ELEC SOLAR SOLID
I
CONDITIONING FORCED AIR ~.w. ELEC. BASE STEAM
. SYSTEM GRAVITY SUPPLEMENTARY AIR CONDo
I
CHIMNEY: A' . ltB' DIRECT)' ENT CON; BURNER
CALCULATED H L()SS ~t''o/JPNv't:. SYSTEM BTU RATINGif f) d't! &r5"
MISC. t:7 a tJ...
INSP. ROUGH IN li'tNAL " It?
EST. costvJ~; orz? P'01?ERMIT FEgS Il-. < p DATg:PD
REMARKS
".1 .