HomeMy WebLinkAbout0009862-Electric (a/c) CITY OF OSHKOSH N o 09862
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ,"PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 21] (1 1 /4(/ Sf1'1{ , PLAN NO.
OWNER .4e- 402-- ��
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 (SC Fgw"
Electric Serv. New ❑ Change Vemp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
770 .
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: V - (TD
a I uatio $ i� Permit Fee Paid $ `f �7 �T Park Dedication $
ISSUED BY / Date , ® /S — 2 2 r Final /O.P. g --- /.5— E
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE L`i g SSC1>_! g —i f-ger
AGENT /OWNER DATE
ADDRESS
TELEPHONE #