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HomeMy WebLinkAbout0041410-Electric N °- 41410 /� CITY OF OSHKOSH `' PERMIT - APPLICATION AND RECORD ' TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ADDRESS 4=.1-C-- /1--- , PLAN NO. OWNER feed---7 Z-.— `-7Z�tw"/w 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 £ :2z rtfrZ [.4- u C L.aC1 Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps 9 Fixtures 7 Switches / Receptacles 1 Circuits O �1 j •.4.A- rt+�.4.-- aLti e.0).4.44 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: Valuatio. $ SD Q 0 ° Permit Fee Paid $ °IP 'CJ c:7 a/ Park Dedication $ ISSUED BY :4 , / /. l. ���v�°�" Date . 9 c�3 IV / Final /O.P. I In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE / i� //�,� 3/ /9 $' AGENT /OWNER 9 0 ADDRESS TELEPHONE # 1pl PERMIT NO. T/ W ° . APPL. DATE ElFC. CONTR. 04 OWNER ADDRESS .05 `� NATURE OF WORK ELEC. SERV. NEW CHANGE T EMP. DESC. TYE VOLTS AMPS FIX'S /.r SW'S RECEPT'S /3 CIRC'S A APPLIANCES IGN _ _ N P. ROUT _N .T!LffN yr = n7S EST. COST s`oo PERMIT FEE Zo DATE PD. 3/95' REMARKS