HomeMy WebLinkAbout0016228-HVAC (furnace) C4 ,"' Plj,1- 1 ,
CI O O KOSH 0 16228
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG UP ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 3 e 5-z/ Ste` 6,t t wermu 1.) r / k't- PLAN NO.
OWNER Data i y R0 i ii
DESIGNER
USE /NATURE OF WORK G [° T'l/ rI2� e' F
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR Ha /^ y ` 'J ` h •
t Heat (i07 A/C ❑ Vent [I] 1 _ Fuel /System 6 . Heat Loss Vi; BTU'S f ' 1 .0Z
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
U 2. lJ`i, "� Park Dedication
FEES: Valuation $ ��i 0",- Permit Fee Paid $ 1 a $
ISSUED BY Date // Nrf Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE —czt.t_^-- / /A e7
AGENT /OWNER ATE
ADDRESS
TELEPHONE #
APPL. DATE a% / PERMIT NO. `L 2 j2
ADDRESS 9 4.5 ' 5:4 'M e c.v® ®Pf 0 r I 'L./
OWNER _ _ _ k r , i -4 Al
NATURE OF WORK 49/a. L e. Cr/N pi Q C
HEATING CONTRACTOR a{'' x H /c//
FUEL: OP OIL ELEC. SOLAR SOLID
CONDITIONING )GFORCED AIR H.W. ELEC. BASE. STEAM
SYSTEM RADIANT SUPPL. A/C VENT
CHIMNEY: 'e' fir DIRECT VENT CON. BURNER
CALCULATED HEAT LOSS L VI `5i- SYSTEM BTU RATING ��. eiY1 -'
MISC.
INSP. ROUGH IN FINAL /g Qv'
EST. COST /tom, Cif, PERMIT FEES y.'lc DATE PD /0/e7
REMARKS
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