HomeMy WebLinkAbout0028763-Electric (a/c) CITY OF OSHKOSH
N2 28763
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC P9 PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / q09 So- b.— . PLAN NO.
OWNER Alafi 4.D. 8 .
DESIGNER
USE /NATURE OF WORK 4-1(1--
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 S � cJcp"
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches X Receptacles Circuit..
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
- Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
- Sink LTub Eject SS Water
Other
FEES: Valuation $ 0 - Cl� Permit Fee Paid $ /0 • r• Park Dedication $
ISSUED BY mod '-? Date / `�/ - 92 — Final /O.P. J ✓� / "��
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE CC L--c_ 4lL /. J —�' —,J._,
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO f _ / . APP DATE - 7 •
ELEC. CONTR. -! �2 �--
OWNER ''` •
&MRF.SS 7�
NA URE OF WORK C%
ELEC. SERV. NEW CHANGE TEMP •
DESC. TYPE VOLTS AMPS
FIX'S SW'S D` RECEPT'S CIRC'S
APPLIANCES
S I"GNS
INSP. ROUGHIN SERVICE FINAL /
Ma, COST / d - PERMIT FEE / Q v DATE PD
REMARKS