HomeMy WebLinkAbout0021300-HVAC_CITY OF OSHKOSH N° 21300
PERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ~ ELEC ^ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
--------------------------------------------------------------------
ADDRESS ~l~_~~Y ~" PLAN NO.
OWNER
DESIGNER
~ ``s t-r ~
USE/NATURE OF WORK ~/~trA'~ i~~.~x '~-
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height .
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR T Ci "' ~Z-~l2 s2 ~~"'
Heat ~ A/C ^ Vent ^ Fuel/System - Heat Loss BTU'S ~~~~r~
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type
Fixtures Switches Receptacles
PLUMBING CONTRACTOR
- BT - WH Disp
- Lav Sh - DW
WC - FDr - SP
-Sink LTub -Eject
Other
Volts
- WSoft
DF
Ur
SS
Amps
Circuits
CBasin
-San. Sewer_
- Storm Sewer
-Water
FEES: Valuation $ ~~'~ - ~~ Permit Fee Paid $ ~~ ~~ Park Dedication $
ISSUED BY "- Date ~~/~ q Q~ Final/O.P. ~d ~02~
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
if ~. _
SIGNATURE
ADDRESS
O 4 9~
DA
TELEPHONE #
APPL DATE__ '~ Q~ PERMIT HO . ~~
ADDRESS ~ ~~Q ~~ ~ ~r
OWNER ~i"~yl ~^-eG`C--YI ~ ! ~ S
HEATING CONTRACTOR
FUEL: ~ OIL
CONDITIONING RC
SYSTEM RADI
CHIMNEY: "A" ~ ~°bIRECT VENT CON.BURNER
CALCULATED HEAT LOSS_~,~Li,r~ SYSTEM BTU RATING~O^(~-~
MISC. ~ "~~_'_ ~
INSP. ROUGH IN FINAL B ~ /~B ~-
EST. COST~J~, ltp_ _ _ PERMIT FEES q.!a~p DATE PD O 9 ~
REMARKS
ELEC. SOLAR SOLID
ED AIR H.W. ELEC. BASE. STEAM