HomeMy WebLinkAbout0008800-Electric (a/c) CITY OF OSHKOSH N2 08800
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC Air PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 0 15 0,i af 2- t.'{ PLAN NO.
OWNER Zd..? 2.S/1,
S/1.-+ x
DESIGNER Al SE /NATURE OF WORK /' cL .
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 55 G-i g2G4Y► Cr
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 $ l00, CC) Permit Fee Paid $ `/ 0 0 Y Park Dedication $
ISSUED BY Date 6 —/-/ g Final /O.P. O — lc - gr ----
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE CL4 e S4 Cl�r 6
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO.e) D U O APPL. DATE "‘ - Tr -
ELEC. CONTR. 'jv1(-4:,
OWNER �'e
ADDRESS 6 —
NATURE OF WORK C
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'S CIRC'S'c
APPLIANCES
SIGNS
INSP. ROUGHIN v G SERVICE FINALG - is 4i
EST COST / 6 O ` PERMIT FEE ' DATE PD4 / -.
REMARKS
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