HomeMy WebLinkAbout0045811-Electric 6//
CITY OF OSHKOSH N ° - 45811
PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECyPLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS l 0 3 PLAN NO.
OWNER >�
DESIGNER
USE/NATURE OF WORK 4 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,Change ❑ Temp ❑ Type t7 /6 Volt Amp� )
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
BT _ WH Disp — WSoft _ CBasin
_ Lay _ Sh DW _ DF _ San. Sewer
— WC _ FDr _ SP — Ur — Storm Sewer
- Sink _ LTub _ Eject _ SS — Water
Other
FEES: Valuation — D O ' ° 0 Permit ,� O✓
r
emit Fee Paid $ Park Dedication $
ISSUED BY Ad jill Date 7/- 1 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 I
PERMIT NO. L4-C11 . A,PPL . DATE
tLEC. CONTR. AX- 44 ;' ,1- "' /A--
R
ar�►vrcc 1 0 3 �a— a —�1,�c ,�i�
NATURE OF WORK
pESC. TYPE vl VOLTS GJ AMPS 2.-0—v
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES
SIamS
FST. COST 2 v PERMIT _ P _ v - •
REMARKS