HomeMy WebLinkAbout009255 - Electric (AC) C■16-) CITY OF OSHKOSH N2 09255
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS - ZO Co A/1-f `)1'`r/yto PLAN NO.
A
OWNER 14) St1- .
DESIGNER �^I
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 SE C E A ---
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
/I 2.-;---
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 $ JO. Ci o Permit Fee Paid $ ! • °C) Park Dedication $
ISSUED BY -- '� Date �/� —�� Final/O.P. 7" /'z eFf-
t
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 11/4 --1Z tc,1 c ( `'} . 7_f 2_-g ~
AGENT/OWNER DATE
ADDRESS TELEPHONE#
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pERmIT N0.
EXEC,
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OWNER fr
ADDRESS ,72- --e7 6 4
NATURE OF WORK
Agf
E EC. SERV. NEW CHANGE TEMP.
VOLTS AMPS
DESC. TYPE SW'S D�_RECEPT' S CIRC_'S'
FIX' S
APPLIANCES
SIGNS FIN ^7 !1 �'�
INSP. ROUGHIN SERVICE
7.7,. ,/ DATE PD
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PERMIT N0. APPL' DATE- _ ,.,
ELEC. C • 4 i,�
104-di
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OWNER hivitir
ADDRESS
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NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX' S SW'S D/,....___,RECEPT'S CIRC'SAc„,
APPLIANCES
SIGNS
INSP. ROUGHIN SERVICE FIN • 74241 41, H I ' , 1
II
S DATE
. APPL
PERMIT NO
ELEC. CONTR.
OWNER eJ 6 .- ���'I/✓
ADDRESS
NATURE OF WORK
NEW CHANGE S S C'
E. EC. SERV. VOLTS CIR --
DE C• TYPE SW,S RECEPT' S
FIX' S
LI AN APP _
FIN � %"�1
SIGNS SERVICE PD
SI DATE Sp. ROUGH N PERMIT FEE '
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IN P
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COST �� �
REMARKS