HomeMy WebLinkAbout0008752-Electric (repairs) CITY OF OSHKOSH N9 08752
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC y< PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS t 3 S 1.&) //-•
PLAN NO.
OWNER /. c,.i/ �,.
DESIGNER
USE /NATURE OF WORK I' ,, p,,i1
•
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 1 1i-k.L E/ L e'
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures ^ Switches X Receptacles p X Circuits
i g) .._ .
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
a GG
FEES: Valuat' • n $ Q �i Permit Fee Paid $ G
/� 1 Q� Park Dedication $
ISSUED B 1L /_�i _/ Date .I� ` ( `O FY
Final /O.P. ...if./
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
4?-/A) iyA/
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #