HomeMy WebLinkAbout0014118-Electric (a/c) CITY OF OSHKOSH
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PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC t < PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ` 4 0 a PUS (I PLAN NO.
OWNER / Y J2 la I
DESIGNER
USE /NATURE OF WORK i
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 E- CY /X)„.- •
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 $ /49G1 Permit Fee Paid $ t;•7 V � Q�j Park Dedication $ c
ISSUED BY �-� Date c - oe / O / Final /O.P. ‘ .2.-• O 9
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE G/ • tom• - 4 4 ,,
AGENT /OWNER ( DAT
ADDRESS
TELEPHONE #
PE - _ T NO. / / . . DATE 1 -�/
CONTR. w i ` ~-
OWNER C3c' - z / /
ADDRESS / `1 _ - » _ _ i - 7
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP
DESC. TYPE VOLTS AMPS
FIX'S SW' S ze...__ RECEPT'S CIRC'S Y )
APPLIANCES
SIGNS
INSP. ROUGHIN vi-C SERVICE N
EST. COST /�--' -- -FRMIT FFF /1 DAM
REMARKS
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