HomeMy WebLinkAbout0026455-Electric CITY OF OSHKOSH N° 26455
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC g PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ((50 LA A t EI PLAN NO.
OWNER j�
DESIGNER 6. a� '� ` U S
USE /NATURE OF WORK
ti.v aiL E Ai €w PO Lt SE
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 2w.zra2S au.
Electric Serv. Ni New S. Change ❑ Temp ❑ Type G Volts /2 2On
Fixtures Switches X Receptacles A Circuits x
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
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FEES: Valuation $ 0 v v � Permit Fee Paid $ � � �� Park Dedication $
ISSUED BY _ Date /go. J — P/ Final /O.P. /— a a - q a
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE • i
—..12—....e
s e AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO . 2 APPL . DA E ! — ? - 7/
r /
ELEC. CONTR
OWNER
ADDRESS
NATURE OF WORK
.4/6' ./ �
ELEC. SERV. NEW DS CHANGE TEMP.
D'ESC. TYRE - v7 VOLTS ?2 AMPS
FIX'S QV - SW'S eC RECE ' S CIRC' S A
- - z , ..
GN / Wire
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N P . ROUGH V/i Z Z:tf aattc RVAISI VAIF S"
EST. COST (0 PERMIT FEE 77, DATE PD.
REMARKS
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