HomeMy WebLinkAbout041217 - Electric (AC) CITY OF OSHKOSH N- 4121 PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /‘' 626 /'7-.
2671-/ PLAN NO.
OWNER "
6'`C-a-ci--711.2'& d.0 /V.-4"
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 47-11-, C/,/�,/ �,GS-6e,
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
-BT _WH Disp WSoft CBasin
-Lay Sh DW DF —San. Sewer
WC _FDr SP _Ur Storm Sewer
-Sink LTub Eject SS —Water
Other
FEES: Valuatio $—/ b f -3/ Permit Fee Paid $ /J
Park Dedication $
ISSUED BY / /4'14"/ 1�.t/t14 �• Date rI'3/9 Y _ 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#
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