HomeMy WebLinkAbout0026166-HVAC (chimney repair)~ CITY OF OSHKOSH N°_ 26166
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ~ ELEC ^ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ~ /~ ~~ ~~ ~ ~ ~~ PLAN NO.
OWNER r ~ ! Z C ~ `~``SO h
USE/NATURE OF WORK _ L-h / ~/~J~ /Z ,vow ~L~SOl2Q /~~ V~-1P/,A/ /+ bL ~ /
BUILDING CONTRACTOR
Size
Foundation
i
Height .
Occupancy Permit
HEATING CONTRACTOR_~FG~yQ/iG:
Heat ~ A/C ^ Vent ^ Fuel/System
ELECTRIC CONTRACTOR
# Stories
Class of Const.
? Yec/ Std ti°G ! ~C
Heat Loss
BTU'S ~'
Electric Serv. New ^ Change ^
Fixtures Switches Temp ^ Type
Receptacles Volts
Circuits Amps
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
- Lav Sh DW DF -San. Sewer
WC _ FDr SP Ur -Storm Sewer
-Sink _ LTub Eject SS Water
Other
FEES: Valuation $ ~ 5,~,~• C~0 Permit Fee Paid $ ~ S ~/ ~ ~ Park Dedication $
ISSUED BY Date ~/7/ ~~ Final/O.P. ~ ~ ^ /5 - gi
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
.iC~r . - -
AGENT/OWNER
Sq. Ft
# Rooms
~L
ATE
ADDRESS f SQO` N. O~ /l `v-p~0'17 f'ry~ ~t.3/ - 5~d?y'
TELEPHONE #