HomeMy WebLinkAboutElectric (temporary) CITY OF OSHKOSH N2 13737
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS /�� PLAN NO.
OWNER "ef 9“ 2----4---7°
DESIGNER
USE /NATURE OF WORK '47
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 —fl
.7 U
Electric Serv. New ❑ Change ❑ Temp l]]-- Type,,L Volts' 6 Amps
Fixtures Switches Receptacles Circuits
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
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FEES: Valuation $ SD Permit Fee Paid $ // /D -�' Park Dedication
ISSUED BY Date /�`��� Final/O.P. 1 9 - P , '
G - - 21
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE ''�` V f AGEN • W R ATE
ADDRESS
TELEPHONE #
PERMIT NO . / 3 37 . APPL . DATE 1 7 ) V g7
ELEC. CONTR. -
OWNER ( Q / a' . r
ADDRESS / 1 1 ..- 2 — t .ii'"5
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP .P
DESC . TYPE 3- Lti - tk$- VOLTS 1 Z /-' AMPS 0 P
FIX'S SW'S RECEPT'5 / B 4- CIRC'S ic
APPLIANCES V
S IGNS C d e )
INSP. ROUGHIN o SERVICE < ' 3 . {j ''Fr /FINAL G -? 1
EST. COST 54'- PERMIT FE DATE PD� 5 -R
REMARKS `J