HomeMy WebLinkAbout0029761-Electric (a/c) CITY OF OSHKOSH N2 29761
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC Jam' PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ac/ 0 ( C / cLt PLAN NO.
OWNER (14 . C - / to y 7 ;,
DESIGNER
USE /NATURE OF WORK A (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 , 5�k.›/
Electric Serv. New ❑ Change ❑ Te p ❑ 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 $ 40 r Permit Fee Paid $i 0 -6\7 • / Park Dedication $
ISSUED BY / ida L.."...∎1 Date ` 7 — 7- 2 —Final/O.P. ' — /7 —Z2--
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE �� �G 4:27
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. ?)74C APPL . DATE
ELEC. PONTR.
OWNER
ADDRESS 7-5 / e , //
N DP WORK i
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES
SIGNS
N -OU.'N ER CE FIN - -
EST. COST PERMIT FEE 02% DATE PD.7
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