HomeMy WebLinkAbout0031828-Electric (misc)CITY OF OSHKOSH N°- 31828
`' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC [g PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /3 6 3 A r°' � PLAN NO.
OWNER
DESIGNER
USE /NATURE OF WORK --
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
A4 Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
` ELECTRIC CONTRACTOR A(!f0 �4 7 � Z_CZ: 7y �---
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches /'< Receptacles K Circuits 2�
PLUMBING CONTRACTOR
— BT _
Lav
—WC
— Sink
Other
WH
Disp
WSoft
_ CBasin
Sh
DW
_ DF
San. Sewer_
FDr
SP
_ Ur
Storm Sewer
LTub
Eject
_SS
Water
FEES: Valuation $ zoo Permit Fee Paid $ v/- Park Dedication $
ISSUED BY / Date /�� '3 %/�- Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
ADDRESS
DATE
TELEPHONE #
AP LANCES
SIGNS
INSP. ROUGH IN, SERVICE FINAL
EST COST !J -- PERMIT FEE,! a DATE PD. -3
E
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