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0043772-HVAC
� CITY OF OSHKOSH N° 43772 � PERMIT - APPLI ATION AND RECORD C TYPE: BLDG ❑ HTG � ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - • - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS /!` U L � w � �� PLAN NO. OWNER ��(J JC–I�7 DESIGNER ' USE/NATURE OF WORK TI`����z-� ��e Gt/ `7�l�2 t� BUILDING CON7RACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit HEATWC� CnNTRACT(�R /'�LlJ 'i.-'f�� : ' Heat � A/C ❑ Vent ❑ Fuel/System�Y .�. 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 _Lav _Sh _DW _DF _San. Sewer —WC —FDr _SP _Ur —Storm Sewer : —Sink _LTub _Eject _SS —Water Other / FEES: Valuation $ �'l� � C� Permit Fee Paid $ � � ` �� Park Dedication $ ISSUED BY Date ��l—��p�_ Final/O.P. ��3 � �� In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE � 0 � AGENT/OWNER pp� ADDRESS � TELEPHONE N