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Home My WebLink About0041162-HVAC (add a/c) �� ; K H N° - 41162 � CITY OF OSH OS � PERMIT - APPLICATION AND RECORD -� � � TYPE: BLDG ❑ HTG � ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ; e: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - � t ADDRESS ��G'L�m/ ��r PLAN NO. OWNER �� '� ��Cj DESIGNER USE/NATURE OF WORK�� BUILDING CONTRACTOR 2 Size Sq. Ft. # Rooms # Stories Height , Foundation Class of Const. Occupancy Permit ; ��ATING CONTRACTOR � • � � Heat ❑ A/C � Vent ❑ Fuel/System �� Heat Loss � �(�� BTU'S d" � �� z ELECTRIC CONTRACTOR ' Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR _BT _WH _Disp —WSoft —CBasin f 3 _Lav _Sh _DW —DF —San. Sewer —WC —FDr _SP —Ur —Storm Sewer —Sink —LTub _Eject —SS —Water Other FEES: Valuation $ �� ' � Permit Fee Paid $ � � ' �� Park Dedication $ ISSUED BY Date��/9% Final/O.P. / �i3 '/Y In the performa e of this work I agree rm all work pur a t to rules governing the described construction. � / SIGNATU ` � A WNER ATE � ��1 �_ � , �/� -�v'J�'� ��76 ADDRESS TELEPHONE# � � �-� �S fl-��'Ul