HomeMy WebLinkAboutElectric CITY OF OSHKOSH N°_ 16002
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC x' PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /e0 0 V C '�1i( - e444Z . - --e
PLAN NO.
OWNER Clx J d ,
DESIGNER �� � J
USE /NATURE OF WORK �i" / !�/ �' A CX
c ).4.2/
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 )0 -'6 ( 2
Electric Serv. New Change ❑ Temp Type ? W Volts idOld Amps .9
Fixtures Switches Receptacles C ' *1) .....
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
Q Ci V
FEES: Valuation $ ' 0 Permit Fee Paid $ d ��--- �— Park Dedication $
ISSUED B / / /�� _ /..�� Date J0 -- �,1 ` ' • Fnal /O.P. /%- cQ 8 9
In the performance of is w rk I agree to per all work pursuant to rules governing the described construction.
SIGNATURE -- ‘.....L--- -- /�� (
AGENT /OWNE DATE `/ ,
/
ADDRESS
TELEPHONE #
PERMIT NO . / P DATE Y ----- ` 77
ELEC. CONTR. GG
�,�:,
OWNER
1T /1. / A
ADDRESS / iC) -
NATURE OF WORK /J
t
ELEC. SERV. NEW 1 `.-, CHANGE TEMP•
DESC. TYPE 1 - '-' ` V VOLTS lZ� 4. v AMPS :2,C9 o
FIX'S K SW's pe_ RECEPT - S AC CIRC' S 4c
APPLIANCES te
etiZe .4 5 . , ' 4; _ .,,5
r
INSP. ROUGHLN "' -'? • ° " 7 SERVICE/ - "- 1 ` FINAL/ - 7
EST. COST .2 7"C0a 8 ` r PERMIT FEE S ° ` ' DATE PD 0
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