HomeMy WebLinkAbout0014864-Electric (a/c)
~
CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
14864
TYPE:
BLDG D HTG D ELEC c!ypLBG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
ADDRESS
PLAN NO.
z:.:=
OWNER
DESIGNER
USE/NATURE OF WORK
o/~
/-c,
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATINf. CONTRACTOR
He~( D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
~--~
--."'.
,
Fixtures
New D Change D Temp D Type _ Volts _ Amps_
Switches t><. Receptacles Circuits f>(
...,
W- '
Electric Servo
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: val"a~ Penn' Fee Paid $
ISSUED BY ======== Date
I CJ ~ Pa'" Dedication $
2? - g -Fe; Final/o.p.!? - g - ? y
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
j/ -Jt~L/
rr
ADDRESS
owNER
-'.
-'Z~ 21~ ~
. =
---.. -- .....--
, ~T >lo./if rib i
lP.'LEC. CON'rR.
cti~~
VOLTS
RECE?T'S
fi~.
AMRS
eIRe'
srG1SS
!P. ROuQFI>l .,' .
FST R~O~"/
SEtW~CE .
PERM~T tEE
^ F~NAll ~
~ DATE pD.
Sli'S
=