HomeMy WebLinkAboutElectric CITY OF OSHKOSH N°_ 24889
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / 6 l / 7 / i /I itC_._ PLAN NO.
OWNER _ '3, r rki
DESIGNER
USE /NATURE OF WORK it/-c-c) /7711
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 _ S _ 6 . 6--- r Alfj4 ,
Electric Serv. Newt Change ❑ Temp ❑ Type b ol Volts/ 4 / 2 0 Amps c "
Fixtures C Switches ?'" Receptacles P C-6 Circuits A9
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
C9 G Q G 1/
FEES: Valuation $ 5 o Permit Fee Paid $ PS ----------- ' Park Dedication $
y
ISSUED BY Date O ' /6 " 7/ Final /O.P. Viii/73
In the performance of this work I agree to •-rform all work pursuant to rules governing the described construction.
SIGNATURE ` < "'"
6+:=2 9
AGENT /OWNER A TE
ADDRESS 2. f ` —6
TELEPHONE #
PERMIT NO. ' 2.11 14 , ir _3/' 9 .APPL. DATE
ELEC. COT O
L °!4
OWNS
ADDRESS "
`� l` /) "'
NATURE OF WORK 4/1/g
ELEC. SERV. NEW tt( CHANGE TEMP.
DESC. TYPE 3 - Lv -- , 4 VOLTS / 2� z y o AMPS c "
FIX'S SW'S 0( RECEPT' S CIRC'S OC
APPLIANCES Y�
SIGNS
INSP. ROUGHIN'%l - - /1 - 11 SERVI X - 7'3/` / FINAL (/€ic3
EST. COST 2 2'o c' ‘..%--- - PERMIT E �EE «S"= DATE PD. '/ Y
REMARKS ` — _ Y
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