HomeMy WebLinkAboutElectric CITY OF OSHKOSH N° 22480
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN p ZONING FLOOD PLAIN HEIGHT
ADDRESS A i 111 :/2," PLAN NO.
OWNER l�
DESIGNER
USE /NATURE OF WORK - /.-emu. �'2/ , 1{ q /
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 /Oa ef.7,��- del--
Electric Serv. New g Change ❑ Temp ❑ Type ll 6 Volts / Amps .. d
Fixtures Switches Receptacles i Circuits 4
AD\
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
4 „ .... , 4 - h:(2.
FEES: Valuatio $ ed Q _1 Permit Fee Paid $ /ZD a Park Dedication $
ISSUED BY ` ► Date pP .2 7 yes Final /O.P. 5' ,1 ci/
In the performance of thi work 1 agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ge..4.--- �� �j'
AG WNER / DA
ADDRESS
TELEPHONE #
PERMIT NO . FO . APPL . DATE /'''
r / `- 5
ELEC. CONTR. IDAZ c.:,
OWNER K6, 0: fr■.
ADDRESS /b (' — A.-4 �f' j. -/ ply
NATURE OF WORK
P
ELEC. SERV. NEW 0S CHANGE TEMP. j
DESC. TYPE lci -- V VOLTS 1 9 z tO AMPS 2,0 O
FIX' $ ��-• ,St4' S IC_._.__ RECEPT' S CIRC' S
APPLIANCES � , � ,1,,,;, (1/ ,rile
S I'GNS
INSP. ROUGHING"'/( L'` 'J�' ' SERVIC / C F
EST. COST 9 00 PERMIT FEET . 4DATE PD -
REMARKS `rp, --