HomeMy WebLinkAbout042163 - Electric (AC) / CITY OF OSHKOSH N� 42163
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC rikr PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /9-7-s" /?7- / , It.' PLAN NO.
OWNER /L0--.l— 7t 2ZKy1 ,44
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 �,C - ee,..„,-Q y'-
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: Valuation : 4i • Permit Fee Paid $ /S�
1 G ' Park Dedication $
ISSUED BY 4.-"✓ -� .,f -rte-- Date (O/3
?` - 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#
PEA�IT N0�
R. DATE
E
C{ ?L ,taitt
OVER
44/94414'
7
ADDRESS I`7 �- /•�i'�J'` �i} c.�,
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES
SIGNS
INSP. ROUGHEN SERVICE F INALNUN
EST. COST /70 . PERMIT FEE DATE PD.
REMARKS