HomeMy WebLinkAbout0005698-HVAC (fireplace & chimney) CAN) CITY OF OSHKOSH N2 05698
- PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /0/9 fi./.i 1 54/ 1 a a& 5 Y ' PLAN NO.
OWNER T To J H / '' J C/ 17
DESIGNER
USE /NATURE OF WORK —.- - t' , If •f P./ v CA /n7// y 51 ke'5
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
t.-- HEATING CONTRACTOR
r
Heat ') A/C El Vent 111 Fuel /System Heat Loss �1/ 5- x i ✓ BTU'S JjJe_
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
FEES: Valuation $ "-- e OW Permit Fee Paid $ /a €`0 Park Dedication $
ISSUED BY Date / D ! Final /O.P. /0 -5-71
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE v 4660/ 4 4, / /a a k '
AGENT /OWNER E
ADDRESS
TELEPHONE #