HomeMy WebLinkAbout0043605-Electric CITY OF OSHKOSH N° 43605
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ,'PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 3 � S't
PLAN NO.
OWNER A,,60,.
DESIGNER
USE/NATURE OF WORK ��.J
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 de..-07'7. tip_
Electric Serv. New Change ❑ Temp ❑ Type' 4 . Volt 4) Amps Z422_
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
f ..
FEES: Valuation $ * ZO° ° • ° Permit Fee Paid $ 5-4 ' ° " Park Dedication $
ISSUED BY Date // /z7 / SSr Final/O.P. 3 "-- ' 7.J
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 1
PERMIT NO. 7 3 60 s ----
' • APPL . DATE / (6 /S y
ELEC. CONTR. .L'- , , / , ,, ,, G ,-
ow 3 � 4-- A,,y L ( 4,_
NATURE OF WORK 1746ri /4?,z/>----
• SW ' S RECEPT'S d v
ERV. ' �/ / CHANGE TEMP.
DESC. TYPE t< h VOLTS � MAPS
C'S
FIX'S t
APPLIANCES /f
o I'
GN
INSP . ROU H N nO�IVAs t t4m111/Q 1�" S
EST. COST °L4&o PERMIT FEE DATE PD.' -7 S J
REMARKS