HomeMy WebLinkAbout040156-Electric 6 (j
CITY OF OSHKOSH N! 40156
PERMIT -- APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /0 3 5 04-0.7_,,, ,i,,--- PLAN NO.
OWNER 7i4m. /J�
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
Electric Serv. New jar Change ❑ Temp ❑ Type 4 /6? Volts 3c4. Amps 7,e, c
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 • c7 O . v o �/
Permit Fee P ai d $ Park Dedication $
ISSUED BY ( -eci, Date 6/Z S1 Final /O.P. (/• / 9• /T
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE L'Z/7
C-i Z 9 L
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
. PERMIT NO. r e / .
,, / _ . APPL . DATE
ELEC. CONTR /I't
OWNER ge...oa 4(/y k,..4.-
ADDRESS /0 3 S 10-
NATURE OF WORK
4-1....d...c_
$,LEC. SERV. NEW CHANGE TEMP.
DESC. TYPE N /67 VOLTS Sul AMPS Z40
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES
SIGNS I7
,INSP. ROUGHIN SERVICE SL /4V FINAL0/�' f
EST. COST 'Z-a- D PERMIT FEE S' ? . Jz)DATE PD. (D/2,i /9 r
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