HomeMy WebLinkAbout0014053- Electric (A/C switch) CITY OF OSHKOSH N2 14053
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC �LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /GG° y/ do LOQ PLAN NO.
OWNER /j-1'-ea-t-e-i
DESIGNER
USE NATURE OF WORK 122L c¢„,„(
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR /1-6-41A-4--
1U-Q- -
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
' 9L-.
Fixtures Switches `� Receptacles Circuits
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
Oma_
./�
FEES: Valuation $ Permit Fee Paid $ ` p�G Park Dedication $ _
ISSUED BY ' ' �/ ��
Date �— Final/O.P. w ~2 7 — 7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR . ��T/��
AGENT/OWNER DATE
ADDRESS
TELEPHONE#
/
PERMIT NO. - z
/ 0 % —) . APPL. DA 5 `Z -8
ELEC. CONTR. �.
OWNER /C1-et-4-c-&',
ADDRESS
0 �-2 = -
NATURE OF WORK —_�
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX' S SW' S Q' RECEPT' S CIRC' S °c
APPLIANCES
SIGNS
INSP. ROUGHIN SERVICE F I1N .tY <y
EST. COST ,moo `- PERMIT FEE /L% `—DATE PD„l-,M
REMARKS