HomeMy WebLinkAbout0027146-Electric CITY OF OSHKOSH N° 27146
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / ?2 fo ' a`
� PLAN NO.
OWNER - L�
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
N
ELECTRIC CONTRACTOR 0-/---si...-------
Electric Serv. New Change ❑ Temp ❑ Type Volts Amps
f ;)----
Fixtures ✓r Switches tom---- Receptacles L"------ 4---- P 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 . $ Sao � �� off 1_
Permit Fee Paid $ Park Dedication $
ISSUED BY Date 4 " - 7 ? Final /O.P. a - J a' -9, a
In the performance of this agree to perform all work pursuant to rules governing the described construction. 4 1%
S IGNATURE i ,I t - L ^7�_
/ AGEl • r R
/// / DATE
ADDRESS
TELEPHONE #
7 1 Cam'
PERMIT NO. . APPL. DATE / 1�
E C. CONTR.
OWNER ¶ ` X -F
ADDRESS / 5:2_ -
NATURE OF WORK
ELEC. SERV. NEW ANGE TEMP.
PESC. TE VOLTS AMPS
FIX'S (/ SW S CIRC'S
APPLIANCES
SIGNS
INSP. ROUGHIN Ck 1 SERVICE FINAL 'S f' -
EST. COST 5 'o - PERMIT FEE ;20= PD..Z - i1 -9y
REMARKS
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