HomeMy WebLinkAboutElectric CITY OF OSHKOSH N °_ 08280
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC *LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS L-0+ 34 1 � O / ' 1 1 0 E PLAN NO.
OWNER Eroc2 g-IYANOtt-
DESIGNER /� n
USE /NATURE OF WORK ___�W & r U f c _- �0 / M/ `'P,
•
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 Sir //'' ll
Electric Serv. New Change ❑ Temp CI Type gW Volts Amps
Fixtures Switches Receptacles Circuits /( ✓
9
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 $ ` • CD Permit Fee Paid $ CO • Park Dedication
ISSUED BY ��2?-12 Date /‘ " err Final /O.P. 9
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE e
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. e 0 1 2 v APPL. DATE - 77 7
ELEC. CONTR.
OWNER � 7 0.,--e//o‹. r
ADDRESS o. ' 3y /- at.4:/ '2]
NATURE OF WORK i iV fr
ELEC. SERV. NEW Dc CHANGE TEMP.
DESC . TYPE - Gti -- v VOLTS f 7 ' 14 d AMPS,2 B a
DC__ FIX'S D SW' S p4 RECEPT ✓S ■ CIRC' S
APPLIANCES // . /. i
7/ -- 641.6.1 SIGNS
INSP. ROUGHI i'lrdn AI MTW - ,
EST. COST / f,,, °- PERMIT FEE O DATE PD
REMARKS