HomeMy WebLinkAbout0043680-HVAC (fireplace) CITY OF OSHKOSH N2
43680
P ERMIT APPLICATION AND RECORD
TYPE: BLDG HTG tp ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS ig 6 f (--k zr <47�' LC/e y PLAN NO.
OWNER '5Ga it J `fka li
DESIGNER
USE /NATURE OF WORK t4 n/ 5 A -7 1/ 4/ f°c.� S ,4e y A ffcp
BUILDING CONTRACTOR
Size Sq. Ft. Rooms Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR &QC/ 17 F PI
t Heat g A/C Vent Fuel /System Heat Loss 4 'S T BTU'S C
ELECTRIC CONTRACTOR
Electric Serv. New Change Temp 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 LTub Eject SS Water
Other
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FEES: Valuation c--`'• Permit Fee Paid /G Park Dedication
ISSUED BY Date W/1 73 Final /O.P. (HO 5 5
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR 4,............
d 2,-
AGENT /OWNER PATE
ADDRESS 047 V/ 75C; 1 i> /4/ G ;65f 4_2=-2 6 7
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