HomeMy WebLinkAbout0034869-Electric (a/c) 142 34869
CITY OF OSHKOSH
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC jr PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS dJ 3 (D CIOVtLS\_. PLAN NO.
OWNER g ifJ 1 c.
DESIGNER
USE /NATURE OF WORK C--
BUILDING CONTRACTOR
Size Sq. Ft. Rooms Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR SE
Electric Serv. New Change ❑J Temp Type Volts Amps
Fixtures Switches X Receptacles Circuits
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation 0 Permit Fee Paid
d q Park Dedication
ISSUED BY Date 7 i7 f3 Final /O.P. 7 4'
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE /Zc k....cj /C."t;3
AGENT /OWNER DATE
ADDRESS
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