HomeMy WebLinkAbout0031928-Electric (misc.) CITY OF OSHKOSH N°_ 31928
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC" PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ‘7,3--- "1,/Cx..ii., PLAN NO.
OWNER 0,-e,,,,ez v/.
DESIGNER
USE /NATURE OF WORK
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 0,....,...: f....e"
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps O
Fixtures N '<....._ Switches Vi=a 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
c o G'
FEES: Valuation $ a d --- Permit Fee Paid $ / ���– Park Dedication $
ISSUED BY Date `. /7 6 2- Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ! j ✓ r 3 � /' 6 a / � // ',�"_
AGE +WNER
D / E
ADDRESS d'3 /Q W /1') /C)A Ze P ry J e � /9/f /NTH L ° 5 13/ d`26
TELEPHONE #
* FT PERMIT NO. ) / � � APPL. DATE //>
ELEC. CONTR. ✓c!...L 1
OWNER
ADDRESS 4 1 1 T �`� G(/ �✓G�`t /G� /
.NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S I. SW'S RECEPT'S + -IRC'
APPLIANCES
SIGNS ,, //
INSP. ROUGHIN SERVICE FINAL /Owe'
EST. COST 150 0% PERMIT FEE .5 - DATE PD
REMARKS