HomeMy WebLinkAbout0000475-Electric (a/c) CITY OF OSHKOSH No 00475
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS '2 3 f 7— 177-,-;j2-a/4/DI
PLAN NO.
OWNER 6 —*/. . i 9 - e - .f./. - — — -
DESIGNER
USE /NATURE OF WORK v
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 CONTRACTO' i •
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 '. ��7 Permit Fee Paid $ Park Dedication $
ISSUED BY / �/ ////L1 a . -- ✓ �''`l -- lam'_ // Y6
Date / Final /O. P. `
r
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE --€ /Le- "l yt_ _
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #
PERMIT NO. 0 4 775 - .APPL !ATE 171 X
ELEC. CONTR.
OWNER (�
z ,
ADDRESS :; ' / ' - ' '2,--r ZY
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
SC. TYPE VOLTS AMPS
FIX'S SW'S / RECEPT' CIRC'S'
APPLIANCES
Qom^
SIGNS
INSP. ROUGHI SERVICE GQ FINAL -l/
EST. COST 7Y/ Y� % PERMIT FEE/Z- DATE PD.7
REMARKS