HomeMy WebLinkAbout0026518-Electric (misc.) CITY OF OSHKOSH N°_ 26518
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 3/ 6 "' ,ve-irli PLAN NO.
OWNER sgOb i t°/ SO 1.-1
DESIGNER
USE /NATURE OF WORK T 4 LC)a e 4 yr e) 1 7 S
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 r'7 C3 'r h !'1 , e--
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
g P .
Fixtures Switches Receptacles i- Circuits 4..----
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
O G BG '/
FEES: Valuation $ D ------ Permit Fee Paid $ �� — � c "� Park Dedication $
ISSUED BY Mg �� . i Date `,2- "'�/ --- < / Final /O.P. /7 /X----
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE — 'ee..--4*tc c- 2- -6 —77
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO 2 6,577 APPL. DATE
✓ •
E C C. CONTR . `'i
OWNER a '
ADDRESS 638- -
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
VOLTS AMPS
FIX'S TYPE SW ' S RECEPT'S. l/� CIRC'S >(
APPLIANCES / r
SIGNS
INSP . ROUGHIN SERVICE FINAL /(- /t 'l
� a s f - j
g ST . COST ! } D ® ' PERMIT FEES — DATE PD .7 - b
REMARKS