HomeMy WebLinkAbout0040554-Electric (A/C)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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40554
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ADDRESS /9/ D 4~ PLAN NO.
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OWNER
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DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Class of Const.
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
Ju~
f
"'.ELECTRIC CONTRACTOR
Electric Servo
New 0 Change 0 Temp 0 Type _ Volts _ Amps_
Switches Receptacles Circuits t2~
t.
Fixtures
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _OW _OF _ San. Sewer
_WC _FOr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
FEES: Valuation $
ISSUED BY
J O. Oc)
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Park Dedication $
Final/O.P.
Date
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
DATE
AGENT/OWNER
ADDRESS
TELEPHONE #
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PERMIT NO. tftJ s~f
ELEC.-CONTF~
Ql<NER fJa-<_. ?t A2Yl:::.
~RESS {910 ~~
NATURE OF WORK
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'~ EC. SERV. NEW
DESC. TYPE
FIX'S
AEPLI~CES
~ b!1PL. DATE foil- 7 f; 'f
SW'S
caANGE
VOLTS
RECEPT'S
TEME .
AMRS
CIRC'S
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SI'GNS
INSP. ROUGHIN
EST. COST jO()'oo
~S
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SERVICE
PERMIT FEE 0.00
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DATE PD:- - V
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