HomeMy WebLinkAbout0013509-Electric (a/c) CITY OF OSHKOSH No 1
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC'PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS Z i f I ( At,...wv,_. PLAN NO.
OWNER f'- } .) 4
DESIGNER
USE /NATURE OF WORK 7s /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
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches v 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 $ D/I Permit Fee Paid $
Park Dedication $
ISSUED BY / f/!::'1 ;J Date .5 — 7-2 — 77 Final /O.P. S _ z g/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE � �,_-1
s --. ? Oy
AGENT /OWNER
ADDRESS
TELEPHONE #
PERMIT NO. - e , .P. DATE -p
E _ C. CONTR. ;� � �I"../
OWNER /
ADDRESS X/
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES
SIGNS
INSP. ROUGHIN SERVICE F INALJ` -1
EST. COST 70 ✓ PERMIT FEE ld — DATE PD.)-zR -aY
REMARKS