HomeMy WebLinkAbout0040565-Electric (a/c) 40/1_,
CITY OF OSHKOSH N2 40565
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECX PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / ,119 c-)>'E -d PLAN NO.
OWNER /6;7'6- /
/C'
DESIGNER
USE/NATURE OF WORK
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
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches 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 $ /00 . O 0 Permit Fee Paid $ E0' D O Park Dedication $
ISSUED BY //� 714..I Date 7/ t 4 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. 4 r . APPL . DATE lP / /Z /`f S'
ELEC. CONTR. J GAA
OWNER 1a. M'cf
ADDRESS /S 9 ■J
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW ' S RECEPT'S CIRC'S
APPLIANCES
SIGNS
INSP. ROUGHIN SERVICE F INALX/ax/C
EST. COST loo , o PERMIT FEE Ja ca DATE PD. 7 /z /sk
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