HomeMy WebLinkAbout0041879-Electric CITY OF OSHKOSH N- 4±879
PERMIT - APPLICATION AND RECORD -
TYPE: BLDG ❑ HTG ❑ ELEC' PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / D 5
,,p PLAN NO.
OWNER a6.r �--
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 4 454€... `I ,-6ii G
Electric Serv. New ❑ Change ❑ Temp ❑ 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 $ 2-0 0 0 , o Permit Fee S 0
e Paid $ Park Dedication $
ISSUED BY 7/t,-,1-4 Date /x / ,V Final /O.P.
In the performance of this work 1 agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
6 /
PERMIT NO. 1 7 4 /1r 7 / . APPL. DATE kb-A y
ELEC. CONTR. (
OWNER 6
ADDRESS 7 0 r / o1.& (I
ATURE OF WORK n a. `
ELEC. SERV. NEW CHANGE TEMP •
DESC. TYPE VOLTS AMPS
FIX'S / SW'S RECEPT'S CIRC'S /
APPLIANCES
SIGNS
INSP. ROUGHIN IC/2-// 'f SERVICE ' FINAL ��
EST. COST 2-° 0 PERMIT FEE S2) DATE PD /Ole
REMARKS