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HomeMy WebLinkAbout0039792-HVAC (furnace & a/c) �o�. � CITY OF SHKOSH N°- 39792 ;. � � ? PERMIT - APPLICATION AND RECORD � TYPE: BLDG ❑ HTG '� ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ADDRESS ��/ ✓—/Y • / ��K�LU PLAN NO. OWNER �d l�7 r'J � �°�/�!O Vf x DESIGNER USE/NATURE OF WORK_�/�t° fivf"'�t�C Cz° bt—/�� �'/G— �� BUILDING CON7RACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit HEATING CONTRACTOR 0 � �� L �� Heat [� A/C [� Vent ❑ FueUSystem /�—�� Heat Loss���S T BTU'S ��U`� � , �Y���� �- 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 $ �d• �`fl Park Dedication $ ISSUED BY Date��.�N Final/O.P. ����� �� In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE + � �����`� 9 AGENT/OWNEfi �-� DA�E ADDRESS TELEPHONE N APPL DATE ����Qy _ PERMIT i(0. 1J2,79 � , ADDRESS ��_`� /�% .�p��ji� (*YNER ��/!Y1 ,Ji�7°IGf"O�I NATURE OF WORK �/QG � �U`'l�t1LG� �-�� �G HEATING CONTRACTOR �Q/�C�v/ FUEL: S OIL � SOLAR SOLID CONDITIONING �OF'ORCED AIR H.W. ELEC. BASE. STEAM ' SYSTEM RADIANT SUPPL. CHIMNEY: "A" "B" �CAIRECT VENT CON.BURNER CALCULATED HEAT LOSS _�'40�'S7- SYSTEM BTU RATiNG ��C/'G'-C� MISC. qt.� � INSP. ROUGH IN FINAL / 9 EST. COST ,�j y�,�;G`tJ PERMIT FEES ��' �t''1 DATE PDG � � REMARKS