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0010996-HVAC (furnace)
� CITY OF OSHKOSH No 10996 `' PERMIT — APPLICATION AND RECORD : TYPE: BLDG ❑ HTG [� ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS n .'� � � �� � �� PLAN NO. OWNER ,��i 4/" ��/ � DESIGNER USE/NATURE OF WORK � � �^ � BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit HEATING CONTRACTOR — � /z �l' Heat �A/C ❑ Vent ❑ Fuel/System -� Heat Loss� x/�5 � 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 $ �� Permit Fee Paid $ ���� l/`�� Park Dedication $ ISSUED BY Date 0 � Finai/O.P. � --�'" �� In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE v" �� � AGENT/OWNER DAT ADDRESS TELEPHONE#