HomeMy WebLinkAbout0040872-HVAC (furnace) CITY OF OSHKOSH N° 40872
P ERMIT - APPLICATION AND RECORD -
TYPE: BLDG ❑ HTG [ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 1 :0 1 / % i'II ea e ' PLAN NO.
OWNER r vi of A p cho /; Tv i
DESIGNER
USE /NATURE OF WORK / /!2G e FlsYl2c
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
9.___ HEATING CONTRACTOR p N U c `C $ P 94- 0,
Heat c A/C ❑ Vent ❑ Fuel /System A, 1.4 Heat Loss 1-/5t BTU'S 6
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 $ WO` Oe C"-Z"' Permit Fee Paid $ 7- Park Dedication $
ISSUED BY Date ehifv Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 7 y
AGENT /OWNER /�/
DATE
ADDRESS
TELEPHONE #
TE_ 1l,�`! y Pte. `f " 7 '
APPL DA
ADDRESS 9)/
OWNER ,4i"neid f /Q so #
NATURE OF WORK R e fJQ c e
HEATING CONTRACTOR
FUEL: l ` OIL ELEC. SELAR SOLID
CONDITIONING FORCED AIR CR. ELEC. BASE. STEAM
SYSTEM RADIANT SUPr.- A!C VENT
CHIMNEY: "A" "B "!!IR$BRV1N+Tf CON . BURNER
CALCULATED HEAT LOSS t t',W" STEM BTU RATING 37J
MISC.
INSP. ROUGH :IN fiat /Of ff
EST. COST .W.o. GAO PERMIT FEES 87e ae DATE PD Y /J /'f
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