HomeMy WebLinkAbout0015269-Electric (a/c) CITY OF OSHKOSH N2 15269
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC VPLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS G ' S _ 1 I ! ,4 PLAN NO.
OWNER 7O4.....) c. Tom +., ott to
DESIGNER
USE /NATURE OF WORK +24 0.%R. CanL'4'so Inert-
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 M 4 - 0 -' 4 a co- i n o-v• d A i c'-
Electric Serv. New ❑ Change ❑ Tem ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits i•-•Vs CI—V
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
_Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
I 1 S O 0 rJ
FEES: Valuation Park Dedication $
a uation $ Permit Fee Paid $ �� �
ISSUED BY__________________ k e��_ 6626 Date 1 /pPO Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 8 /2_9 /8p
AGENT /OWNER DATE
ADDRESS
TELEPHONE #