HomeMy WebLinkAbout0014110-Electric (a/c) CITY OF OSHKOSH N°_ 14110
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC k ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS X/ 30 /CA- iiCti 'c _ PLAN NO.
OWNER P A krs .
DESIGNER
USE /NATURE OF WORK A , 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 _..- �-E'�t (
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches L.----- Receptacles Circuits `� )CC/
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 $ / Permit Fee Paid $ l " Park Dedication $
ISSUED BY 41440- IP A_..." ✓ Date ‘ _2 a Final /O.P. (O `- "— ”/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE / f' AGENTIOWNER DAT
ADDRESS
TELEPHONE #
/ 7 / ‘ -/ -,2_
PERMIT NO. P DAT
R. 2 ELEC. CONT }
OWNER / V �- -A-14
ADDRESS
2-1- ',22
NATURE OF WORK ,4 J 7
ELEC. SERV. NEW C/ CHANGE TEMP
DESC. TYPE VOLTS AMPS
FIX'S SW'S P RE(EPT'S CIRC'
APPLIANCES
SI
EST. OSTGHIN . COST /00n-=- n PERMIT FEE D DATE , -$%
ET
REMARKS
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