HomeMy WebLinkAbout0002702-Electric (service) CITY OF OSHKOSH Ho 02702
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC k PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /e) / / „/Zo /' L: 0 •
PLAN NO
OWNER
DESIGNER
USE /NATURE OF WORK 6
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 ,
•
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps l "
Fixtures , Switches Receptacles Circuits '6D,
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
, Aa v/
FEES: Valuation $ Permit Fee Paid $ Park Dedication $ Q
ISSUED BY i , b Date / ""..7...7---- / Q�J ! �'r / G Final /O.P. " !�.(7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE �� de ' _z.. IF
Z -1-7
i r AGENT /OWNER DATE
ADDRESS
TELEPHONE #