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HomeMy WebLinkAboutElectric (temporary) CITY OF OSHKOSH N9 19487 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ( LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ADDRESS /6 � PLAN NO. OWNER , •. 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 � Electric Serv. New ❑ Change El Temp tr Type Vol �y d Amps a e' Fixtures Switches Receptacles C Circuits K 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 FEES: Valuation $ 6 -- Permit Fee Paid $ A © ®`�_ `� Park Dedication $ ISSUED BY Date /r-Ye Final /O.P. `r_...2. ` -Fe, In the performance of this work I agr- : perform all work pursuant to rules governing the described construction. \' / / SIGNATURE ■ ■iillb. =rd • / AGE /OWNER DATE ADDRESS TELEPHONE # / gill-7 - � PERMIT NO. . APPL. // TE V I 4 OWNER ADDRESS `lO — C/ \ ("r"—el *4 NATURE OF WORK ELEC. SERV. NEW CHANGE TEMP. DESC. TYPE 3 - w - c' 4. VOLTS l � cf.0 AMPS Le 6 t FIX'S SW'S RECEPT'S ��( CIRC'S,3 APPLIANCES V SIGNS ,,� << INSP. ROUGHIN SERVICEL y 24 - y O FINAL `( -4o, EST. COST i.4 l PERMIT FEE /0 c - PD'2-113.-fe REMARKS