HomeMy WebLinkAbout0031690-Electric CITY OF OSHKOSH N2 31690
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECk PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS p 725 - !� - f ��% -Ll47 T.X PLAN NO.
OWNER 9 j
DESIGNER
USE /NATURE OF WORK v( .Z/-1. ' 4.-4--‘ 1 e0`t,e---1‹
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 '
Electric Serv. New I Change ❑ Temp ❑ TypeJ/ Volts 4 Amps c„...)...49 �`�
Fixtures P 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
dF at V
FEES: Valuation $ 'pro '� Permit Fee Paid $ O .S " ---- Park Dedication $
ISSUED BY Date/ /7 — yam Final /O.P. T' ' 9F
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE / � /1 / 2 / ?
AGENT /OWNER DATE
ADDRESS /-,� , • _ ...yr.., 4/AP � � � ,.� / .
TELEPHONE # �4
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PERMIT NO. /
5-/—/-7-1,
. APP . DATE / —/ 7 .0..—_
ELEC. CONTR. A` .
OWNER��'� /
„ADDRESS
NA - OF WORK 4
-ELEC. SERV. NEW D5 CHANGE TEMP.
DESC. TYPE 3 1 4 - — V ,-- VOLTS 1 ° �''0 AMPS..io e
FIX'S A SW's /x RECEPT S Ase CIRC' S X
APPLIANCES
LI'GNS r f �� ,
N P. ROUGH N 0 • i -a- - 4. ) SERVI 4 F N• %- i
E . COST O . . (PERM T F- rgf:1.41,1
REMARKS N .4 - ,c) o 1 - - 7 -
,v - 7 2 .i_92
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