HomeMy WebLinkAbout0006869-Electric (GFI)CITY OF OSHKOSH N° 0.6869
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC 21---P-LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS 4,4 t 7::, A,i K I ) PLAN NO.
OWNER Lo +L ,' rV c kL,
DESIGNER j
USE /NATURE OF WORK a�A d
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System
# Rooms
# Stories Height
Class of Const. Occupancy Permit
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Lr— Circuits
9
PLUMBING CONTRACTOR
BT
WH
Disp
WSoft
Lav
Sh
DW
DF
WC
FDr
SP
Ur
Sink
LTub
Eject
SS
Other
FEES: Valuation
r
ISSUED BYE
CBasin
San. Sewer_
Storm Sewer
Water
AN
Permit Fee Paid $ �� Park Dedication $
Date Z- ;2- ' Final /O.P. i -- / `Z, � �r
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
DATE
ADDRESS
TELEPHONE #