HomeMy WebLinkAbout0044451-Electric (a/c) !o /�
CITY OF OSHKOSH N °- 44451
` PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECX PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /D 2-0 177d/i...-644-4---d PLAN NO.
OWNER �_.-4c - te�
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 atc &L7
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 $ ( d O , v 0 Permit Fee Paid $ /4
Park Dedication $
ISSUED BY , ! __.u./�.f f _ Date `t // Z'/ S S�
Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
fo / "L
PERMIT NO. V 4445- 1 . APPL . DATE
ELEC. CONTR. t ie- o►�
OWNER PP -t
ADDRESS -149
NATURE OF WORK
ELEC. SERV. NEW %��-- CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES
SIGNS
INSP. ROUGHIN SERVICE FINAL
EST. COST / e-o PERMIT FEE /o DATE PD.'/ 02/9, -
REMARKS