HomeMy WebLinkAbout0023122-HVA C(a/c) C - • r) CITY OF OSHKOSH N° 23122
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG p ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS „ A e r 1 44 . 11 PLAN NO.
OWNER ✓ d hn 0 L? r- -! r
DESIGNER
USE /NATURE OF WORK Add /4"/C--
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR Nap x V *7 r Heat ❑ A/C [9 Vent ❑ Fuel /System Heat Loss �Y /1 v BTU'S -�
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
7
FEES: Valuation e �� O, 4119 uation $ �� Permit Fee Paid $ O` Park Dedication $
ISSUED BY Date 0 9/4/ Final /O.P. 6/ 71 >/
In the performance
.^ of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE £ _ 0 q /Q�
AGENT /OWNER !DATE
ADDRESS
TELEPHONE #
APPL DATE (Q q PERMIT NO
ADDRESS / /or
OWNER 4
NATURE OF WORK ":01,10/ G
HEATING CONTRACTOR / /"
FUEL: GAS OIL
SOLAR SOLID
CONDITIONING FORCED AIR H.W.
SYSTEM ELEC. BASE. STEAM
RADIANT SUPPL. C VENT
CHIMNEY: "A" "B"
CALCULATED HEAT LOSS DIRECT VENT CON.BURNER
MISC. �s��`s SYSTEM BTU RATING_
INSP. ROUGH IN
EST. COST FINAL 17
REMARKS PERMIT FEES DATE PD