HomeMy WebLinkAbout0020304-Electric CITY OF OSHKOSH N9 20304
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC [ —PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / /6J �/✓ , ' PLAN NO.
OWNER :. =.- ' `�� i ' , ‘-li
DESI I 1 ER
7f ..
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
System
ELECTRIC CONTRACTOR
E lectric Serv. New []- Change ❑ Temp ❑ Type`k Volts / e) Amps
Fixtures L — Switches Receptacles 2----- Circuits 4----- 4°
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
cC �
FEES: Valuation $ o�® ` Permit Fee Paid $ 5 , "' o'^ Park Dedication $
ISSUED BY 'G Date 7' l `! G 4, Final /O.P. // -5'
In the performance ` Al. of this work I agree. perform all work pursuant to rules governing the described construction.
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SIGNATURE '� i e `
r, ' ' T /•' NER / A T E
ADDRESS
TELEPHONE #
PERMIT NO. ;2\49 3?‘',"(
f APPL. •ATE ��l"
ELEC. CONTR. �/►
OWNED // ='
ADDRE S ��'�`
1 — � •
NATURE OF WORK ' ' "
• SERV. NEW Air
• TYPE Atli- •
CHANGE
FIX'S - SW'S _ VOLTS / Q TEMP,
ANCES RECEP ' S �� `'iPS , oe,
CIRC'S
I /l
I P. ROUGH N
R COST d SERVICE,/ . -/ - ?D FINAL 1^ •
EST.
"KS PERMIT FEE p '
DATE PD. - O
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