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0021586-Electric (boiler)
� CITY OF OSHKOSH N° 21586 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS ��lC� �L-�'Id c'i � PLAN NO. OWNER S `���1� DESIGNER . USE/NATURE OF WORK��P) I / �' n BUILDING CON�"RACTOR 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 CONTRACT�R_T , D °e ��1 ..� Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches � Receptacles L-- 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 ► a� a� '�EES: Valuation $ � `�— Permit Fee Paid $ l �`�- Park Dedication $ ISSUED BY Date �l`- �� - �� Final/O.P. ll—�� `�l/ In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNA � ��"-��p � �G' AGENT/OWNER DATE ADDRESS TELEPHONE# �