HomeMy WebLinkAbout0017211-Electric (furance) CITY OF OSHKOSH N°_ 17211
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC VPLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / . Sy *'/ tr) A 9 s e' / eft►' PLAN NO
OWNER / Y I c.R - /to 4A Sa rt r 5 e.
DESIGNER
USE /NATURE OF WORK 1..o /2 e 40I4. n*.. t 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 / Q 42 X 4 e 4. 1' ^S 4 " 1 4k
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits i/ 90 1/4.
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
® L d G
FEES: Valuation $ e —""— Permit Fee Paid $ . Park Dedication $
ISSUED BY /�� 2 � ` / � Date - � Final /O.P. �- _
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE •, 4 11 ".01 /"1". 2.1 / if 9 a
" AGENT /OWNER DATE
ADDRESS 3 70 5 iL/ ■ 14,4 Er V /L' i s /T /f ✓G ,
TELEPHONE #
2
PERMIT NO / 7 , APPL . DATE/
ELEC. CONTR. G?
OWNER ` IF�f� "_"
, / /
ADDRESS
NATUUF OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW' S RECEPT' CIRC' S9
APPLIANCES
SIGNS
;NSP. ROUGHIN ERVICE F INAL 2 -"29C'
EST. COST l = PERMIT FEE /D DATE PD? ..? 9D
REMARKS
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