HomeMy WebLinkAbout0041864-Electric CITY OF OSHKOSH N2-41864
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS x' 3 3 PLAN NO.
OWNER /7A /f
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 < ' - , lee`'
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
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FEES: Valuation $ � So. 0 Permit Fee Paid $ g8 O 0 Park Dedication $
ISSUED BY jr 4 1,4(4 -/V --0-7--- Date 6 3 9 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #