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Home My WebLink About0041789-HVAC (replace furance & add a/c) � v � ITY HKOSH N� 4�.789 � C OF OS D PERMIT - APPLICATION AND RECOR TYPE: BLDG ❑ HTG-� ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS ��,� « � g� �✓� PLAN NO. OWNER lJ /�`4'�lCe l.l�f�'f i. �E' DESIGNER USE/NATURE OF WORK� d� `L' � v�"�� f� � �� G— $UILDING CONTRACTOR , Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit HEATING CONTRACTOR r��3 S�''N S �T' 9'- ,[T�L 7� Heat� A/C (�Vent ❑ Fuel/System ��- Heat Loss��f�� BTU'S �a1�"� �r � .� �s� /�-�G 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 $,�' �� Park Dedication $ ISSUED BY Date��/�l� g�— Final/O.P. � �`�� tn the performance of this work I agree to perform all work pursuant to rules governing the described construction. ` n SIGNATURE �\�" \G--�� C_� � AGENT/OWNER D TE ADDRESS ` � !�� i� �� TELEPHONE�k