HomeMy WebLinkAbout0013005-Electric (a/c) n CITY OF OSHKOSH No 13005
`' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS—/ �� �/�• /��� ,/ ' ''L– - PLAN NO.
OWNER � �-Z��
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 �/G'G C� r G /`C c
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles 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
FEES: Valuation $ r� � Permit Fee Paid $ �� Park Dedication $
ISSUED BY Date ��� ���/ Final/O.P. � /- ~ � ����
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE � t � �� �
AGENT/OWNER DATE
ADDRESS
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