HomeMy WebLinkAbout0029756-Electric (a/c) CITY OF OSHKOSH N° 29756
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ,'PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS e774 g I /t14/L5A4 t(-- . PLAN NO.
OWNER _____I CA/1- fk 0 t t • - % - - G; .
DESIGNER
USE /NATURE OF WORK 4 --- / 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 LSLOi>
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches /S 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 / 0. Permit Fee Paid $ /0-0'0 " Park Dedication $
ISSUED BY „/L Date 7 • � `/ 7-7 -2-
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE i Lcc 7 6 JO--
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO
9 75-- . APPL . DATE -.0- r /
E LEC. CONTR. L.... ' / - --..
OWNER � � �/
ADDRESS . . -/- / , , , „ „ „( ,
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S
SW'S D C RECEPT'S CIRC'S 4'
APPLIANCES
SIGNS F INAL 7--/7-12 INSP. ROUGHIN SERVICE
EST. COST ! 60 f PERMIT FEE /a° DATE PD .7Vl7%2
jtEMARKS