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0013960-HVAC (add a/c)
� _ CITY OF OSHKOSH No 13960 PERMIT APPLICATION AND RECORD TYPE: BLDG ❑ HTG � ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT f . ' ' ' ' ' ' ' ' ' ' ' ' ' � ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' _ ' ' ' ' ' ' ' ' ' ' ' ' ' ' . ♦ C�, ADDRESS_ y�� LU � �/�'/ /�v � PLAN NO. OWNER I�Dh (��DGUL�� DESIGNER USE/NATURE OF WORK �� �(� S �'� �e 1 BUILDING CONl"RACTOR Size Sq. Ft. # Rooms # Stories Height _ Foundation Class of Const. Occupancy Permit HEATING CONTRACTOR — v' Heat ❑ A/C �Vent ❑ Fuel/System �r—° Heat Loss �s 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 �< <�'� Permit Fee Paid $ ��� Park Dedication $ ISSUED BY �, Date � �� Final/O.P. ��lf^� ' In the performance of this work I agree to perform all work pursuant to rules governing the described construction. � SIGNATURE � ���� �!� �� AGENT/OWNEA pA . ADDRESS � TELEPHONE#