HomeMy WebLinkAbout0019869-Electric (a/c) CITY OF OSHKOSH N2 19869
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS lI� � � 1 l � r' I/ Gt J / PLAN NO
OWNER A ' 1 vi f a , -1 H 7 6- .
DESIGNER
USE /NATURE OF WORK L -€ ` -1. 71-- ( 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 CONTRACTO /'e C t1/" t G Ga✓',O •
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches — Receptacles Circuits C- -
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
O G G i
FEES: Valuation $ /.J� Permit Fee Paid $ /• Er____-.
Dedication $
ISSUED BY Date ?- lQ -- pe , Final /O.P. G ( 62 70
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE Q`L �lil� g -' /e " 9•
GENT /OWNER DATE
ADDRESS
TELEPHONE #
I
PERMIT NO. / 91"g APPL. DATE - 1/ . > .
ELEC. CONTR. �
k
OWNER ‘ /5 712.
ADDRESS ,.., '
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S p( RECEPT'S CIRC'S \
APPLIANCES
SIGNS
IN P. ROUGH N SERVICE FIN' -/O
EST. COST 'iJ1 PERMIT FEE ° DATE PD. / ""
REMARKS /'S—
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