HomeMy WebLinkAbout0012441-Electric (remodel) CITY OF OSHKOSH No 1
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC1PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
7Q � �
ADDRESS / `. /�/ � � r_ PLAN NO.
OWNER � 1-1-4.0—..&--
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 A' ' ,t- "
Electric Serv. New ❑ Change Temp ❑ Type Volts Amps /
Fixtures ____X___ Switches Receptacles Circuits X ill ,
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 f 160. �6
FEES: Valuation $ /C2 O Permit Fee Paid $ f � Park Dedication $
ISSUED BY l Date 3 / " 7 / Final /O.P. 3 ` / 77
In the performance of this work I agree to perfo m all work pursuant to rules governing the described construction.
/
SIGNATURE
AO _ • r' / ir
AGENT /OWNE DATE
ADDRESS
TELEPHONE #
PERMIT NO. ` , APPL. DATE /
ELEC. CONTR. ..
OWNER Xe2 ./P-e/1/1-4/3
ADDRESS
/5 -
v t Gh -�-
NATORE OF WORK
P_XsiVvv
EL;SC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
RECEPT'S (NL
APPLIANCES
SIGNS
INSP. ROUGHIN Y SERVICE FINAL
EST. COST 2--‘ ` PERMIT FEE /!Oi DATE PD.3 - ?1
REMARKS