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0016721-Electric (a/c)
~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 16721 TYPE: BLDG D HTG D ELEC ~G D SIGN D ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - .. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - USE/NATURE OF WORK /~/7 7/~~/ / - < ' .7/~ Cl ~ C< PLAN NO. ADDRESS OWNER ~.. DESIGNER BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. HEATING CONTRACTOR Heat D AlC D Vent D Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR ,?(~- .Ai' J a~~ '" Electric Servo Fixtures New 0 Change D Temp D b(..... Receptacles Switches Type _ Volts _ Amps_ P\ Circuits v. ; PLUMBING CONTRACTOR _BT _WH _Disp _ WSoft _ CBasin _Lav _Sh _DW _DF _ San. Sewer _WC _FDr _SP _Ur _ Storm Sewer _Sink _ L Tub _ Eject _SS _ Water Other Permit Fee Paid $ Date /t:J~ /.:2- -( ~ -~7 Park Dedication $ Final/O.P. I:L --/1.../ -7;;- ISSUED BY In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE .A~a ~ AGENT/OWNER / a;~r/v9 ADDRESS TELEPHONE # l?~RM'I'tNO. 1& /~ DA't~ cJr-I-t" ~~C. CON'tR. O~~R ~DR~SS ,A'tURE OF woRK 't~Mi . AMES C'IRC'S S~R~'IcE. PERM'I't FEE --