HomeMy WebLinkAbout0015263-Electric (furnace) 41.) _CITY OF OSHKOSH N° 15263
PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC VPLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / 6/ (2 F n n Q $ lG- ..S.-Y. PLAN NO.
OWNER /V) a-/2 /"fe. /
DESIGNER
USE /NATURE OF WORK t 'ot in5 I c.2ilaC e-
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 + -/i- K Neal i a /4/4—
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
.c:: I._._.___._____ ,
Fixtures Switches • 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 $ /2 S. Ott f
Permit ee Paid $ �� O D` Park Dedication $
ISSUED BY # I, �- it , , i . ' _ ,47ir'. Date / /ry Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE C' f /
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
`,---E APP . DATE " d - 8
PERMIT NO. /
C. CONTR. �/ A..r ...,i. � 4 ..
OWNER �, •
*DRE S
NA RE OF WORK r . ti
CHANGE TEMP.
ERV. NEW VOLTS AMPS
' • TYPE RECEPT'S CIRC'S
FIX'S SW' S c
r ERVICE FIN 9 "
N P. ROU H N =� DAT PD, � 9"'r
E COST ! 20 f------ PERM _ T FEE
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