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CITY OF OSHKOSH HEATING PERMIT L
APPLICATION AND RECORD /t
Date_ ~- /- 7~ Application N~ 3 6 9 2
i ype of Fuel:
Gas
Coal
Other
Type of Heating System:
Forced Air (number) _ /
Steam (number)
Unit heater (number)
New heating system __.~ Replacement of:
Conversion Burner
New Used
Calculated Heat Loss
Size of Unit(s)
Miscellaneous Work to Heating System _
Heating Contractor
Address ~ ~
Valuation of Work _ ~- ~~- ~r Fee -~-~~
Electrical Contractor
Oil
Electric X
Hot Water (number)
Gravity (number)
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.
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(Signed)
Add
(BY)
Address
Owner
Heating Inspector
Final Inspection % ' ~a 7 7 K ~ Q