HomeMy WebLinkAboutElectric CITY OF OSHKOSH No 01933
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC •■■ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
./6 ✓ice - /7/ :_e_e -(
ADDRESS PLAN NO.
OWNER •
DESIGNER
USE /NATURE OF WORK .7 7-e-A " -) g (S-14--- '
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 Z1.
Electric Serv. New Er6 L`2 hange ❑ Temp ❑ Type'4/ Volts ' Amps � -0-ej '
Fixtures x Switches X Receptacles /< Circuits A 171)21
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 $ - T-
Q , v V
Permit Fee Paid $ 7 Park Dedication $
ISSUED BY �// ��i _ _:-i--ma / Date L/ 7 ✓k Final /O.P. / / /c
In the performance of this work I agree to perfo m all work pursuant to rules governing the described construction.
/
SIGNATURE / -e-� ` �� •
/ /OWNER DATE
ADDRESS v
TELEPHONE #
PERMIT NO. IP 7 7j 3 APPL. DATE 9 —
ELEC. CONTR ee 4
OWNER
ADDRESS / to - - �-& -, 7 L
NATURE OF WORK 1 t h ,d--e-e----P yyy ���"'���
t
ELEC. SERV. NEW CHANGE TEMP. t
DESC . TYPE _� VOLTS 1 4 AMPS /ea
9 C.,_ FIX'S o SW'S RECEP S - '
�,of p
CIRC S
APPLIANCES �
SIGNS ��'' �� `,/,(4,64.e.(0
INSP. ROUGHIN dk - 7 - 1&- $ ERVICE K9 - ' O j
EST. COST / - NAL -/D
P ERMIT FEE } U ATE PD,//-7 -gb
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