HomeMy WebLinkAbout0021460-Electric CITY OF OSHKOSH N2 21460
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC -PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /65- C�.-- - PLAN NO.
OWNER - ' e � - '
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
ELECTRIC CONTRACTOR _ .e4A
Z.-..--3
Electric Serv. New E ❑ Temp ❑ T Y pe "t Volts ` 4).- T - Am P s
Qe'
Fixtures ` ' 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
FEES: Valuation $ /(5 `"� Permit Fee Paid $ 4. '� Park Dedication $
ISSUED BY Date // - ?Z Final /O.P. //` a 9-90
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
....._ 411 1,, /
SIGNATURE �' /I i1 / Jam' - ` °
, OF-4w AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. / �� � . APPL . DATE / O r -5'
ELEC. CONTR.
OWNER • - %
ADDRESS / :v e - 4,-02
NATURE OF WORK 4/V-4- rJ
ELEC. SERV. NEW CHANGE TEMP.
DESC. T 4pE 3 - c✓ - v 4 VOLTS/,'' AMPS/"4
FIX'S v SW'S pc. RECEPT' S v ky CIRC' S K
APPLIANCES
1/
S GN /IiIIIIII=1111:7
INSP. ROUGHIN SERVICE•' l6 - 2 - 7& FINAL
EST. COST /,SpO'` PERMIT FEE 5 DATE PD 1/4 90
REMARKS
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