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HomeMy WebLinkAbout0021458-Electric CITY OF OSHKOSH N° 21458 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC Tr/GLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ADDRESS //jet • �''� G7< PLAN NO. .„/ ... 0_ 4_4....,___ . OWNER .--A 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 e e.02_,_.....7.7 . ELECTRIC CONTRACTOR Electric Serv. New Change ❑ Temp ❑ Type k" Volts P LI ° Amps Fixtures t/ t- i ure Switches Receptacles Circuits `---- 4:::2______ 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 G Ci FEES: Valuation $ 6 � `% / / Permit Fee Paid $ .©`� Park Dedication $ ISSUED BY �j Date `l2 —7 / Final /O.P. � a / a In the performance of this work I a•ree to perfor• all work pursuant to rules governing the described construction. SIGNATURE ��� �� � re' /OWNER DATE ADDRESS TELEPHONE # PERMIT NO. APP'L . DATE ELEC. CONTR. OWNER O </( ADDRESS NATURE OF WORK /®� ELEC. SERV. NEW ���// CHANGE TEMP. DESC . TYPE J w - VOLTS /25 '10 AMPS /O ° FIX'S pC SW' S RECEPT''S CIRC' S X APPLIANCES SIGNS INSP . ROUGHIN 9/ > ID-- /O SERVICE FINAL /2 EST. COST I 00 PERMIT FEE " - DATE PD / -q'9O REMARKS