HomeMy WebLinkAbout0014904-Electric (a/c) CITY OF OSHKOSH N° 14904
- PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC IE PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / o?/ 3
7'iser -: PLAN NO.
OWNER a.,.c _,„ 7K
DESIGNER
USE /NATURE OF WORK 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 . Ce
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps SL
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
' .e - � L
FEES: Valuation $ Permit Fee Paid $ < �i —p Park Dedication $
ISSUED BY Date 7 9 Final /O.P. c
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE
AGE /OWN & ATE
ADDRESS
TELEPHONE #
/A?( P . _ DATE r
/ f AlV
PERMIT NO. `
ELEC. CONTR. y
OWNER
1L--
/-
ELEC. SERV. NEW CHANGE TEMP . VOLTS ANDS
�
DISC. TYPE CIRC'S 1
FIX' S SW' S , _ R]:CEPT' S
APPLIANCES
SIGNS SERVICE FINAL 5'`/
EST . COST OSTGHIN
5 a J PERMIT FEE l'' DATE PD.79 _gy
EST.
REMARKS
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