HomeMy WebLinkAbout0014103-Electric (a/c) CITY OF OSHKOSH N° 14103
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ''PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS J7( /icL"t PLAN NO.
II
OWNER / f /r
g .
DESIGNER
USE /NATURE OF WORK l 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
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits t
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 $ O O Permit Fee Paid $ l Park Dedication $
ISSUED BY /4L� � ,.�s Date / - -.2 i ' Final /O.P. - -87
..
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE °'�/�.-ft-vLt c-a -c- Z-- . ( A �/
AGENT /OWNER D E
ADDRESS
TELEPHONE #
PERMIT NO./ 'r / 0 ) .APPL. DATE - i
ELEC. CONTR. ,/. ��'G�; Z
OWNER ' / l'I "< ",- 't.
ADDRESS l )---/‘ - (9.1-1# . - A
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S 2_. RECEPT'S CIRC'S,
APPLIANCES
SIGNS
INSP. ROUGHIN , SERVI FINAL Y .
I EST . COST / 0 CL-- PERMIT FEE / G' — � DATE PD ‘-.21 $5?
REMARKS
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