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Date tJ - ~- .- '1 R
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CITY OF OSHKOSH HEATING PERMIT
APPLICATION AND RECORD
Application N~ 3856
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Owner JJ!~ H
Address /dSZ ~
Building Use mn .
Type of Fuel:
Gas
Coal
Other
Oil
Electric
New heating system
Conversion Burner
New Used ..,
Calculated Heat loss ~ ""'" ~ :;:::.~ 0 -/1 0
Size of Unites) '3 ~ L _~ _
Miscellaneous Work to Heating System I
Type of Heating System:
Forced Air (number)
Steam (number)
Unit heater (number)
Hot Water (number)
Gravity (number)
Replacement of:
Heating Contractor ~ 7If:
Address 2 S- L~
Valuation of Work f4 2' ?J~
Electrical Contractor
~e ..tt;;, 0(:>
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)
Add ress
(By)
Address
Heating Inspector
Final Inspection
Owner
Agent
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