HomeMy WebLinkAbout0029757-Electric (a/c) CITY OF OSHKOSH N°_ 29757
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC �PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ,9 - ) 0 c / S4`. PLAN NO.
OWNER j(JP S dibr --
DESIGNER
USE /NATURE OF WORK A /
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 Sc G il
Electric Serv. New ❑ Change ❑ Temp ❑ 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 $ M �� Cri) Permit Fee Paid $ /V- q F inal /O. P. Park Dedication $
ISSUED BY � •', " ,` Date 7 "! / 7 / -Z- 6 / 7Z
/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 4 L LC5 71 –,_■•
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. 975 7 . APPL. DATE
ELEC. CONTR. _.%
OWNER
AQDRESS C
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S ®t RECEPT'S CIRC'S A<
APP IANCES
SIGNS
INSP. ROUGHIN SERVICE FINAL' - / 7 92-
EST. COST ' / 4 d ° � - PERMIT FEE le, ° i DATE PD .7 -/
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