HomeMy WebLinkAbout0034810-Electric (a/c) CITY OF OSHKOSH N° 34810
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 9 toa PLAN NO.
OWNER aaj !
DESIGNER /�
USE /NATURE OF WORK (.[. .0 �Jj
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 1 EX_[�
Electric Serv. New ❑ Change ❑ Temp er Type Volts Amps
Fixtures Switches 4� Receptacles —1r-- 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
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FEES: Valuation $ -------- Permit Fee Paid $ lO Park Dedication $
ISSUED BY Date F /O.P. 7 /,
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATU
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. 3e//r) APPL . DATE AP — -7 }
ELEC. CONTR. ,hh,b• _ 4ppp-
OWNER ` GIG
ADDRE S
NATURE OF WORK Z(0
C. SERV. NEW CHANGE TEMP .
C. TYPE VOLTS AMPS
FIX' S SW'S AMPS
AP LANCES
SIGN
NSP. ROUGH N SERVICE
FEE c7 TINAD
EST. COST d PERMIT
RF�,MARK DATE PD. - ,y