HomeMy WebLinkAbout0043982-Electric CITY OF OSHKOSH N 43982
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELECLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS
4) k.V_ k e lc 4)c y` PLAN NO.
OWNER -"w
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DESIGNER
USE/NATURE OF WORK E' J- 4 t---
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 ld'L r
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits 1
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 /Pyjee Paid UED BY i�sie 4
In the performance of t is work I agree t. perform all work pursuant to rules governing the described construction.
SIGNATURE 4 vrt ,A 1
&J /I AGENNT /OWNER DATE
2
ADDRESS -!S
.4, M f 1 7i
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