HomeMy WebLinkAbout0013117-Electric (a/c)
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CITY OF OSHKOSH N~
PERMIT - APPLICATION AND RECORD
13117
TYPE:
BLDG D HTG D ELEC ~LBG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
ADDRESS :11" i-\ ~ ""'; U. c '" Sf. PLAN NO.
OWNER LJ (?. b d", \3 t Oc....1 "-
DESIGNER
,
USE/NATURE OF WORK lAJ ~ (1- e 0,_ . n.- C III A. J ,J -0 ",,"oJ. '
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat D NC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR M Co.-(t.. It. \-+ v. -i ''''--s 0I--fA...1. l'f:.:\ "<I! e.J...d Ie .
Electric Servo
Fixtures
New D Change D Temp D
~. Receptacles
Switches
Type_ Volts_ Amps_
Circuits ~
10
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
FEES: Valuation $ \ "7 9,00 Permit Fee Paid $
ISSUED BY ~~_ Date
\'5.00
S-=-3-Y- ;7
/
Park Dedication $
,r- a cG
Final/O.P. ....) - J - 0 I
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE 4/ ..J "/h~~---
AGENT/OWNER
.~/31 g~
DATE
ADDRESS
TELEPHONE #
ADDRESS
~ATURE OF WORK
~EC. SERV. NEW
D . TYEE
llX'S SWIS
~'LIANCES
~rGNS
INSP. ROUGH N
EST. COST I ",/ b
~EMABKS
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PERMIT NO.
LEC. CONTR.
OWNER
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TEMP. . ~
AMES ' ::
CIRC I S '<'
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-
SERVICE
PERMIT FEE
=
F IN,AL b .q -~
o~~ATE PD..1~ J
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