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CITY OF OSHKOSH N° 46986
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECf PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / 0 6 S 4Z 4C /A / PLAN NO.
OWNER dye (/ , � A.,/
DESIGNER ��
USE /NATURE OF WORK geed j�'`� -e--
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ NC ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR �J�llt/1�
Electric Serv. New Change ❑ Temp ❑ Type' Volts3� Amps w
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
CF-S-- FEES: Valuation $ 3 0-� Permit Fee Paid $ 0C/�• J
Park Dedication $
ISSUED BY 9.--X--- Date 0 / 3 ° ft C Final /O.P. 0 / 7 / 5$
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 #
W r/ 6, 9
PERMIT NO. A �d . APPL . DATE
ELEC. CONTR .3L4/`4.A . A .,
OWNER '1, �--
ADDRESS 1 0. S ,f . 146/
NATURE OF WORK
E RV . CHANGE , ( 0
DESC. VOLTS 3 c,✓ AMPS 7-01)
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES i
SIG NS k
ii �
INSP. ROUGHIN re�6i�' SERVICE r / z y A. r FINAL 1 1 III
EST. COST 7 �"--" ' PERMIT FEE / DATE PD. 2..4/S
REMARKS
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Electric Permit Work Card
Job Address 1055 LAGGER LN Permit Number 0000000 Create Date 12/7/95
Owner LEGACY BUILDERS Contractor ZWIERS ELECTRIC
Category 611 - Residential -New Single Family Wirin
Service 0 New O Change 0 Temp Type 0 Overhead 0 Underground
Volts Switches u Neon Sign Neon #
Amps 200 Fixtures Neon Transformers #
Circuits Receptacles Value $0.00
Appliances
Use /Nature
of Work
Inspections:
Date 12/7/95 Type Final Inspector is Approved