HomeMy WebLinkAbout0026165-HVAC (chimney repairs) /CITY OF OSHKOSH N °26165
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG r ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS S/) 6 G(J . `' S' ,t- ' PLAN NO.
OWNER S l ' •eve JdAits0 `i
DESIGNER /�
USE /NATURE OF WORK C'4 i m h 1 ?p tfa a/2ar 1/ 121 'it °It 5- o4 / `yr PS' � .
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR / rl va Lt C t'c� CA 4/ /9.(i 5 "i: /f /,575
E Heat ❑ A/C ❑ Vent ❑ Fuel /System -- Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation $ / 7 • a, Permit Fee Paid $ .4� < C I., Park Dedication $
ISSUED BY Date 7/1/9/ Final /O.P. I 'D — / 4 - G1 )
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE .. jai" 44-g h� ��
Q AGENT /OWNER �DATE
ADDRESS 9 '-s - 96 ti• 0 /f /C -1 " - di s p e7v 4. ' /- 4 ,9..,7 9
TELEPHONE #
APPL DATE / ,/7 /5/ PERMIT NO . 4 ; 1 -4 /G5 -
ADDRESS y� Pp (, ef t s -
OWNER Ste (/ e c Mini S ®vi
NATURE OF WORK Gh /I71 -PiG504ep g-erw/ r Y-, //h es^S'
HEATING CONTRACTOR /I1. 14 0 c ��i�/ "4'0 S / aI .75
FUEL: GAS OIL ELEC. SOLAR OL D
CONDITIONING FORCED AIR H.W. ELEC. BASE. STEAM
SYSTEM RADIANT SUPPL. A/C VENT
CHIMNEY: "A" "B" DIRECT VENT CON.BURNER
CALCULATED HEAT LOSS SYSTEM BTU RATING
MISC.
INSP. ROUGH IN FINAL f . /f q /q/
EST. COST 070z2 .c/.p PERMIT FEES 1 DATE PD//)/7/4y
REMARKS