HomeMy WebLinkAbout0010735-Electric (fixtures & switches) CITY OF OSHKOSH N2 10765
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC(PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /c/o 1 1 ivy.. PLAN NO.
OWNER . rO ! ` Fra4-k6i S
DESIGNER ,Q ms �j�
USE /NATURE OF WORK OUf S )6& J/1 e`- fiX ,
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 (5 W-el-
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures e ) ( --- Switches Receptacles Circuits AL'
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 $ Oe Permit Fee Paid $ /-1• fi, Park Dedication $
ISSUED BY 44,-4._ Date 7‘ 6 -- O Final /O.P. 1 — ` ro
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ! t/ lO 1J U
AENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. /1 77) APPL. DATE 7 -2-7-
ELEC. CONTR. ;,'
OWNER 7a-,,, ,,t-0----cr--
ADDRESS Zf_ a _
NATURE OF WORK
App L, Ate , -
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW — RECEPT'S CIRC'S
APPLIANCES
SIGNS
INSP. ROUGHIN SERVICE FINAL 6 d
EST. COST 7017.5!-S-- PERMIT FEE -1 DATE PD/d
REMARKS
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