HomeMy WebLinkAbout0044802-Electric (a/c) & iz- -
CITY OF OSHKOSH N ° - 44802
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / 0 - 0 ee � A PLAN NO.
OWNER
DESIGNER
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 /14
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 $ ( • o 0 Permit Fee Paid $ -C
Park Dedication $
ISSUED BY ?"1-'1"/A Date S /S � 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. k e (ft * 3 • APPL . DATE
ELEC. CONTR.
OWNER
ADDRESS 0 E O
NATURE OF WORK /,'Z
ELEC. SERV. NEW CHANGE CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES
SIGNS FINAL
INSP. ROUGHIN SERVICE
EST. COST / Z 1, . b PERMIT FEE (S DATE PD. - I <f9l
REMARKS