HomeMy WebLinkAbout0013029-Electric (a/c) CITY OF OSHKOSH N2 13029
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC,PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ' 2„60 , 5 SO-fa. PLAN NO.
OWNER � / v I _s...-Ar -
DESIGNER
USE /NATURE OF WORK A j 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 Receptacles Circuits 1 •
1�
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 $ /9 d Permit Fee Paid $ /'a ✓ Park Dedication $
ISSUED BY Date 1 Final /O.P. / — >7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE. �'2of+ ^ %4( G fC.Gc /
AGENT /OWNER / DA
ADDRESS
TELEPHONE #
PERMIT NO. / D APPL. DATE `L. =1
ELEC. CONTR.
OWNER e J�-�
ADDRESS /7,2- / -
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'S CIRC'S X.
APPLIANCES
SIGNS
INSP. ROUGHIN SERVICE FINAL! 19
EST. COST / D0 � PERMIT FEE / #`_�5ATE PD. H -2S,(g
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