HomeMy WebLinkAbout0019920-Electric CITY OF OSHKOSH N9 19920
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC -PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ie.. d4-- PLAN NO.
OWNER G2.0-te-1.. 4 �� � .
DESIGNER J USE /NATURE OF WORK �%� I bCib 1 -- Y 1f 1•`O cM.,
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 (Se G -
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches 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 $ f Do- cr-E, Permit Fee Paid $ 70 - .--'"/ Park Dedication $
ISSUED BY Date /3 -,e Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
4 , __<, , SIGNATURE cc. / <S - / 2
AGENT /OWNER AT O
DATE
ADDRESS
TELEPHONE #
PERMIT NO. / 0 . APP\ DATE - � —
ELEC. CONTR. seT-e--- _
OWNER ��
ADDRESS VW—
NATURE
OF WORK g
ELEC. ERV. NEW CHANGE TEMP.
DF,d r M
VOLTS AMPS
FIX'S Cp��W' S Tom- RECEPT' S
APPLIANCES
SIGNS
INSP. ROUGHIN 4K -$' � �4C SERVICE FINAL
EST. COST / G � ° ' l PERMIT FEE / - - DATE PD.27 /3-
REMARKS
{