HomeMy WebLinkAbout0014398-Electric 46) _ CITY OF OSHKOSH N2 14398
PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC Aj PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 2:/321 F)61ag' LYO PLAN NO.
OWNER �01 V A elU' 4
DESIGNER
USE /NATURE OF WORK l 66 reki601
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 ' #LLI • _. 1 / _
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches \ Receptacles Circuits y la)9■CL
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 $ 6 '' Pe rmit Fee Paid $ 5 ----- Park Dedication $
ISSUED BY Date 7 /I 'gy Final /O.P.
In the performance of thi • I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE , d. LI / (Ji '- /j
A T/0 R DAT ,497
ADDRESS
TELEPHONE #
PERMIT NO. v App . DA
ELEC. CONTR.
OWNER CPQ5-n
ADDRESS —
NATURE OF WORK
jr�'7iI7r'
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S of SW'S RECEPT'S CIRC's -
APPLIANCES
SIGNS
INSP. ROUGHIN7i`1 -5 -f -dr SERVICE FINAL
E ST . COST /zap PERMIT FEE fp % DATE PD. /1-07