HomeMy WebLinkAbout0040946-Electric 6Iz
CITY OF OSHKOSH N2 40946
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC1' PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS e GL PLAN NO.
OWNER 2 . �..�'dr
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 C �ls WirthA-'-A- �i -- 06
Electric Serv. New ❑ Change ❑ ❑ Type Volts 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
/
FEES: Valuation $ . O 0 • o 0 Permit Fee Paid $ /S c Park Dedication $
ISSUED BYp �,f.a.r. Date E/5 `i' Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
r Z -
PERMIT NO. r v Q . APPL. DATE / /ci `T
ELEC. CONTR. ace-07f
OWNER p 1! ,
ADDRESS .2- ' /% "` terril
NATURE OF WORK
ELEC. SERV. NEW CHANGE TE .
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'S CIRC'S
•APPLIANCES
SIGNS
INSP . ROUGHIN Z / L4 ' SERVICE FINAL
EST. COST ZD-O .o. PERMIT FEE 0 DATE PD.V/V
REMARKS
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