HomeMy WebLinkAboutElectric CITY OF OSHKOSH N o 11162
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC < PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / PO A lien /LL- ,4. PLAN NO.
OWNER M4 ari7k / /4-ii W
DESIGNER j USE /NATURE OF WORK /� /4»- i -
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 LG//t'i1V11 ri/� C /f'C"T/?- %Cl1 Old TW1 q ,)--
Electric Serv. New, Change ❑ Temp El Type 1/6 Volts %90 Amps 2615
Fixtures X Switches /V Receptacles )C. Circuits k h
/ f
.
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
C6 C C-
FEES: Valuation $ �� C) ' Permit Fee Paid $ �5 �"� Park Dedication $
ISSUED BY ` %G`;�:� A,,e._t /
Date L /'" 7 - - Z Final /O.P. /2 -i
In the performance of this work I a ree to perform all work pursuant to rules governing the described construction.
SIGNATURE �� '�
/
AGENT /OWNER I TE
ADDRESS
TELEPHONE #
PERMIT NO. / / 6 L APPL. DATE - .Y - S 2r
ELEC. CONTR.
9 / c: ;e
OWNER A 4
ADDRESS
/1,zr - $ -e L
NATURE OF WORK 112/16-7-
ELEC. SERV. NEW CHANGE TEMP.
DESC . TYPE ? -- (-(i - l./ VOLTS ` � 5--'�v AMPS /OG
FIX'S _ SW'S k RECEPT'S CIRC'S
APPLIANCES la
S IGNS c ` ( ( -zCt?y l i
INSP . ROUGHIN _ °-d,PS 2/` $$SERVIC i'A 6--3 - - S) - FINAL a Pig
EST. COST o2 SOO — PERMIT FEE 71' - DATE PD. - - D
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