HomeMy WebLinkAbout0005157-Electric CITY OF OSHKOSH NO 05157
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECX PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS PLAN NO
OWNER /. L v' / '
DESIGNER
USE /NATURE OF WORK i 1 . ".— ,,,S0-
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 t
Electric Serv. New ❑ Change ❑ Te ❑ Type Volts Amps
Fixtures . c - Switches Receptacles ------ Circuits
9
PLUMBING CONTRACTOR
- BT — WH _ Disp WSoft CBasin
- Lay _ Sh _ DW _ DF _ San. Sewer
— WC — FDr SP Ur Storm Sewer
- Sink _ LTub _ Eject SS Water
Other
FEES: Valuation $ 5 ( ) - ` fs
`
Permit Fee Paid $ //97 Park Dedication $
ISSUED BY Date 2 7 -77 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 00-----i
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #
PERMIT NO. f 5 5l APPL. DATE 7 3 g7
ELEC. CONTR.
OWNER
41h, �-
ADDRESS /7A (G
NATURE OF WORK �.
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S 17" SW'S 7— RECEPT'S CIRC'Sk
APPLIANCES
SIGNS
INSP. ROUGHIN er r. SERVICE FINAL
EST. COST / 572 — PERMIT FEE „1. DATE PDX ?7'7
REMARKS