HomeMy WebLinkAbout0014113-Electric (a/c) CITY OF OSHKOSH N2 14113
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC 7PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / //�yb _._
PLAN NO.
OWNER SC'I a., .
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
Electric Serv. New ❑ Change ❑ Temp El Type Volts Amps
Fixtures Switches v Receptacles Circuits 4
9
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 $ M Permit Fee Paid $ 7‘1 V Park Dedicati n $
ISSUED BY Date r
"-' _ Y7 Final/O.P. _ V7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE /i�i�sy >`�G� ‘Zd /;
AGENT /OWNER � DATE
ADDRESS
TELEPHONE #
P T NO. APP . DATE i r /
ELEC. CONTR , �
. / ''
OWNER G /
ADDRESS /5 3 -
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S 7 RECEPT'S CIRC'S
APPLIANCES
SIGNS
INSP. OSTGHIN . PERMIT FEE /0 DATE N PD. 26' �?
EST. COST /� ad V � /
REMARKS
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