HomeMy WebLinkAbout0041228-Electric (a/c)
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CITY OF OSHKOSH N~ - 41228
PERMIT - APPLICATION AND RECORD
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ADDRESS
/27 ø /~é?f
~Á~~,/~£Ç
PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat 0 NC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
~~4V
/
f.2ù ~
Electric Servo
Fixtures
New 0 Change 0 Temp 0
Type - Volts - Amps -
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT _WH
_Lav
_Sh
_FDr
_Disp _WSoft - CBasin
_DW _DF - San. Sewer
-SP _Ur - Storm Sewer
-Eject -SS _Water
_WC
_Sink
Other
_LTub
Permit Fee Paid $
Date
/
0:'-,00 I
o/z-3h$l (
Park Dedication $
Final/O.P.
ISSUED BY
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER
DATE
ADDRESS
TELEPHONE'
(, /7.--
PERMIT NO. if/;2 z...r- ,APPL. DATE ?/Í.P!t""
ELEC. CONTR. #~
OWNER
,- ADDRESS I:;.. 7 áJ, I t¡F é;Ç
NATURE OF WORK
aM. ~
CHANGE
VOLTS
RECEPT'S
°ELEC. SERVo
DESC. TYPE
FIX'S
APPLIANCES
NEW
TEMP.
AMPS
CIRC'S
SW'S
SIGNS
INSP. ROUGHIN
EST. COST. fl
REMARKS
SERVICE
PERMIT FEEl.!.': c>
FINAL
DATE PD.
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