HomeMy WebLinkAbout0009267-Electric (a/c) CITY OF OSHKOSH N2 09267
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC,PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS -1-1C0-7 �/y // PLAN NO.
OWNER ji2h^ 4.
DESIGNER /c..
USE /NATURE OF WORK A
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 .64 _ v L_
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches \ Receptacles Circuits/ XL"
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
FEES: Valuation $ /0 . 07) Permit Fee Paid $ q. 02.3 Park Dedication $
ISSUED BY .7 .,-'', Date 7 -/.- "T7 Final /O.P. 7 — .7.g ---
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ij P Lc5 ka.7
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. � 2 - 7 APPL. DATE
ELEC. CONTR.
99
ADDRESS J l 74 °1741
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW S pc RECEPT' S CIRC' S
APPLIANCES
SIGNS
INSP. ROUGHIN 6 SERVICE FINAL7 - /i
EST. COST / bd � PERMIT FEE 'f di DATE PD?-1-a-0
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