HomeMy WebLinkAboutElectric CITY OF OSHKOSH N2 10953
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC RiG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
l / /
ADDR 3(p ��� (O ' \ O L°" - �l ` / PLAN NO.
OWNER /‘ / C /C &G• O u. L A--
DESIGNER
USE /NATURE OF WORK / P •° 116 cc., %pGc- `E'-
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 /a v' .- 7� P/
Electric Serv. New ,_,_, C / han e Temp Q
L'T g ❑ p ❑ Type � Volts�� Amps °
Fixtures 1..--- Switches L '� Receptacles � � Circuits 1----- ,
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 $ IQ 6 0 0 � � Permit Fee Paid $ re, °',_
Park Dedication $
ISSUED BY / /AG* i Date °/5 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE .I�`. _ .d 4 /(1
AGENT /OWNER ATE
ADDRESS
TELEPHONE #
PERMIT NO. Z 71-/ . AP: L. DATE - % 7
ELEC. CONTR. /
k 44,0ic
OWNER (A/L-c- r ,d !�
ADDRESS i 2' /=e, _ / f //
NATURE OF WORK
ELEC. SERV, NEW l< CHANGE TEMP.
DESC. TYPE 3 - (A- - ti VOLTS J -0 Leo AMPS 00
FIX'S K S f oL RECEPT' S CIRC' S DX
APPLIANCES i $ •
./%! L2ii� r �I
IGNS / +� • -
INSP. ROUGH N fTion ' .1:', F N , i -
EST. COST 6 o v PERMIT FEE , — DATE PD ' -/ -%(
REMARKS
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