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Home My WebLink AboutElectric �jZ CITY OF OSHKOSH N° 33003 � PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG []CiE�C ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS �"��' G �� ` • PLAN NO OWNER �� DESIGNER /'� USE/NATURE OF WORK "`"-�'� 1 ✓"�'-`"��V2 '�"�� 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 FI F(�TRI(' C'ONTRA('TOR 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 n�_. o - FEES: Valuation $ � oU Permit Fee Paid $ �S q Park Dedication $ ISSUED BY � Date �J ��J �/ 3 Final/0.P. In the performance of this work I agree t perform all work pursuant to rules governing the described construction. �a � ��/.T�3 - SIGNATURE AGENT/OWNER DATE ADDRESS TELEPHONE k � PERMIT NO. �� J L�� , APPL. DATE � — � `�� _ ELEC. CONTR. �iliL��2<zi,i� C��ttc _ OWNER �� ADDRE.SS � � � — — NATURE OF WORK � — �-2-� "`Z ...�-c-.-.�� 1 ELEC.• SERV. NEW CHANGE TEMP. DESC. TY E VOLTS AMPS FIX' S SW' S RECEPT' S !C CIRC' S _ APPLIANCES = SIGNS INSP. ROUGHIN SERVICE FINAL EST. COST ;Zf/CJ - PERMIT FEE /S-"� DATE PD3 �/S�YO REMARKS