HomeMy WebLinkAbout0023151-Electric CITY OF OSHKOSH N° 23151
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC $ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
kA ADDRESS 1,4 01 U'E 2 2 /+M f PLAN NO.
OWNER eIt te-I 4 t_ j'
DESIGNER A / 1
USE /NATURE OF WORK ' '` .3/4) 1
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 `,/e tv+ t/C. CL£c-77JC.4L /3 -,AJc
Electric Serv. New g Change ❑ Temp ❑ Type 11 Volts / Amps 2. '"
Fixtures x Switches k Receptacles )l 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
dC G G
FEES: Valuation $ a Permit Fee Paid $ � '/ ✓? Park Dedication $
ISSUED BY -- T , Date a -7/ Final /O.P. 7 - 2 - i r
In the performance of this work I agree erform all work pursuant to rules governing the described construction.
SIGNATURE /
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AGENT/OWNER ,) A TE
ADDRESS / �f ) i& t�4 /�/ o f �/i�t6 9 z s =G a go
TELEPHONE #
PERMIT NO . 3/51 . APPL . DATE 7 /- 50 - 7/
ELEC. CONTR. .0.11 _ ���� - - -
OWNER '
ADDRESS lee 4L
NATURE OF WORK 44%/
ELEC. SERV. NEW X CHANGE TEMP. o .
DESC. TYPE J - v VOLTS 9 °' AMPS a
FIX'S SW'S oc RECEPT'S CIRC'S �}
APPLIANCES V
SIGNS
INSP. ROUGHIN G -T:. / SERVICE 1 1 FINAL?'' /
EST. COST S J PERMIT FEE ,Sew DATE PD .�-J4 - �/
REMARKS
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