HomeMy WebLinkAbout0003674- Electric (A/C) CITY OF OSHKOSH No 03674
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC,' PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /00$ /u. I PLAN NO.
OWNER riCirCf /1,4)k_
DESIGNER
USE/NATURE OF WORK 5 P „,i)w c i
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 frd”,-k L z l d r. (-C-t
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits > Tarr ,, 117:16- 1,-.
,
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
G /
FEES: Valuation $ S)•�� Permit Fee Paid $ Park Dedication $
ISSUED BY j��%� /j1-� Date 5 --(/—K) Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE l› rS2c-i— C • 5----//--E 7
AGENT/OWNER DATE
ADDRESS
TELEPHONE#
3ERMIT NO. C 36 7APPL. DATE �- g 2
? 4 �1 LEC. CONTR. £ 1C.
h A
OWNER4 _a--
.DDRESS / C d S^ - /1
JATURE OF WORK _
ELEC. SERV. NEW (�/ CHANGE TEMP.
)ESC. TYPE VOLTS AMPS
?IX' S 9 1.4/ 2`---- RECEPT' S CIRC' S OS
APPLIANCES
3IGNS
[NSP. ROUGHIN SERVICE - FINAL ' -2Z g7
EXT. COST dam_ PERMIT FEE `✓ DATE PD., /!-$7
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