HomeMy WebLinkAbout0014054-Electric (a/c) CITY OF OSHKOSH N2 14054
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS l.- 9 'Au- 0-c PLAN NO.
OWNER l `y
DESIGNER
USE /NATURE OF WORK
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 ep�_
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits r
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 $ Permit Fee Paid $ /6 `�— Park Dedication $ c
ISSUED BY (-1Z2% Date 4e G� Final /O.P. (O / - 27
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE _ r �Ar� / /�� /Qyh
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AGENT /OWNER DATE T
ADDRESS
TELEPHONE #
/ 5-1 ,r
PERMIT NO. l Q - P. DAT G F
ELEC. CONTR.
OWNER r .0---,
ADDRESS / 2 ZZ
NATURE OF WORK C5e
g LEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'S CIRC'S0
APPLIANCES
SIGNS
INSP . ROUGHIN SERVICE G FINAL, ° .2 9Pi'
E EST. COST 5 o °''." PERMIT FEE / 2 - -- - 'D ATE PD. (E 2 ? 6
REMARKS
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