HomeMy WebLinkAbout0045869-Electric (a/c) CITY OF OSHKOSH N ° - 45869
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECX PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN . HEIGHT
ADDRESS 3 3 3 �cZ PLAN NO.
OWNER /V /
JJJ
DESIGNER
USE /NATURE OF WORK C2 -. (•/5 -�
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
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 • 7 , Permit Fee Paid $ l - v ti' Park Dedication $
ISSUED BY � 1 6 Date ? 677 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE M
PERMIT NO. 4/ �e //6'' 9 . APPL . DATE
ELEC. CONTR. i ��`il
OWNE I w /1
, ADDRESS ? 3 3 3 -
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES
SIGNS ,,,,�
INSP. ROUGHIN SERVICE FINATu''V� V
EST. COST // b • Z ‘' PERMIT FEE ld r a e DATE PD.7inigi
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