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0028379-HVAC (a/c)
� CITY OF OSHKOSH N° 28379 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG � ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS �� 5 � v� h �A�l2 u �9� PLAN NO. OWNER U`7�'f (J h �'�'!/c.r DESIGNER USE/NATURE OF WORK j����/ �/G �� BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit HEATING CONTRACTOR �`C� J � � � Heat ❑ A/C �p Vent ❑ Fuel/System J rG Heat Loss �� �/ 5 T BTU'S ELECTRIC CONTRACTOR Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps � Fixtures Switches Receptacles Circuits . PLUMBING CONTRACTOR � t —BT _WH Disp _WSoft —CBasin F —Lav —Sh DW _DF _San. Sewer —WC _FDr —SP —Ur —Storm Sewer —Sink LTub _Eject —SS —Water Other FEES: Valuation $ �,�� � ��D Permit Fee Paid $ /�� �� Park Dedication $ ` �/�� 9� Final/O.P. � ��-�� ISSUED BY Date �,T , In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE � ���WNER DATE - ADDRESS �iJ 7? �.5�'T �2���- ��+'.�✓f�[�.�J� � �Z'7�Q Z- TELEPHONE# PERMIT NO.� 3�� APPL. DATE ���� annxESS �-�/�'h /�r h� d� oW�R r�>ti � ���� l�_� NATURE OF WORK � � ` HEATING CONTRACTOR �G`� ���r .� FUEL: GAS OIL � SOLAR SOLID � 1(WiPiITIONING FORCED AIR H.W. ELEC. BASE STEAM SySTEM GRAVITY SUPPLEMENTARY IR COND. CHIMNEY: "A" "B" DIRECT VENT CON. BURNER � CALCULATED HEAT LOSS L lc�'� � SYSTEM BTU RATING l �� J7>`j � � MISC, � � INSP. ROUGH IN FINAL Le Q'L EST. COST /�(�p . �(�PERMIT FEES �7�!/Y� DATE PD REMARKS - �