HomeMy WebLinkAbout0023775-Electric (a/c) 41) CITY OF OSHKOSH N2 23775
- PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC' PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ) Jh) / A PLAN NO.
OWNER fffle. ... cc" 4-2_ /
DESIGNER
USE /NATURE OF WORK 74 f /
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 S G 1
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
6
Fixtures Switches ,, Y 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 $ /Ca Permit Fee Paid $(0- q Park Dedication $
ISSUED BY Date ‘—le, `7 / Final /O.P. °/ " -7/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE Pt – ci<-l--?-1 10 -- 2/
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. / / ,APPL. DATE 7
ELEC. CONTR. ,AP-"wv
OWNER _ _ _ _ '
_ r
ADDRESS / V / / -� c.4S/�
NA URE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'S CIRC'SD�
APPLIANCES
SIGNS
INSP . ROUGHIN SERVICE FINAL 6 -/" 41
EST. COST 419 P ` ■s PERMIT FEE/0.52.1==- - DATE PD.G -)OAF/
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