HomeMy WebLinkAbout0042432-Electric (temporary) o C°I
CITY OF OSHKOSH N- 42432
`' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ® PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 0 7 1 9 CZA..Q,t /r/J PLAN NO.
OWNER u./
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 et i- fi.A.,4/ I
Electric Serv. New Change ❑ Temp Type Volt3w Amps, d
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
d
FEES: Valuation $ S":0 0 Permit Fee Paid $ / 00.1e / 0 ' d-' Park Dedication $
ISSUED BY Date 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 #
6®/
PERMIT NO. t L .APPL. DATE
ELEC. CONTR. 1
OWNER ,',C °
ADDRESS - 7-,. 20 L .e
NATURE OF WORK
//IAA)
g . SERV. JEW ( CHANGE TES
DESC. TYPE tA id i VOLTS 3 iA AMPS
.IX'S SW'S RECEPT'S 4 CIRC'S
APPLIANCES
S
MP 0 L( 1
; N$g N. ROyGHIN SERVICE 1U' v FINAL
EST. COST '7 �'r PERMIT FEE o.mom DATE PD./0
REMARK