HomeMy WebLinkAbout0016859-Electric CITY OF OSHKOSH N°_ 16859
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC V PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / / a S 1/4-6-6 2,4,41t PLAN NO.
OWNER 0/V ae.s ? A/092-71f
DESIGNER A )�,, 1
USE /NATURE OF WORK `� '"") 474/10
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 ChJ ,
Electric Serv. New Change ❑ Temp ❑ Type "16_ Volts f Amps
Fixtures Switches Cs Receptacles Circuits 7'‘
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
,..?�9J
FEES: Valuation $ ®B Permit Fee Paid $ ,51.7 cv Park Dedication $
ISSUED BY Date ! — " `2) Final /O.P. ‘ – 4 T 9°
In the performance of this work I agree to pe - .11 work pursuant to rules governing the described construction.
SIGNATURE / ' ' .- '0
/) AGENT /OWNER BATE
ADDRESS / i
TELEPHONE #
PERMIT NO.
D . APP . DAT ESL 2 -//
ser
ELEC. CONTR. f�
OWNER C _ /170/4 1
ADDRESS //2.
N R_ 0 WO'
ZLEC. SERV. NEW b- CHANGE TEMP .
DESC. T'WE -'v - t/ VOLTS «"�-wU Amps 2.
FIX'S SW' S RECEPT S ( CTRC S A
APPLIANCES a .2, % / j (c4 %62
SIGNS � - - I L ' • L� R CE _ _'9 ' '�' tia
N. • ROT _ ' " � '
EST. COST j o d DATE P D. / - 90 ' — PERMIT FEE
RE SARK per/
{