HomeMy WebLinkAbout0005951-Electric CITY OF OSHKOSH N °_ 05951
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC "PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
4
ADDRESS 2575 X PLAN NO.
OWNER 7'
DESIGNER
USE /NATURE OF WORK 0 —"���
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 l_. e
Electric Serv. New Change ❑ m p ❑ Type Volts Amps
Fixtures C-/ -*---- Switches receptacles L----- 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
/ m
FEES: Valuation $ ` 40 61 O � _ Permit Fee Paid $ �® �. 7 Park Dedication $
ISSUED BY ' %; Date �� 2L — 7 Final/O.P. - i f '17
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE L D _�M — 7
C AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. Z S9 . APPL. DATE ! - 7
• ELEC. CONTR.
OWNER 2::77)
/
ADDRESS 25 / -f -- L --
NATURE OF WORK J/l
ELEC. SERV. NEW oS CHANGE TEMP_
k., }ESC. TYPE ) — k — t/6 VOLTS 1 �� 'td AMPS /o a
S SW'S °S RECEPT' Or CIRC'S 4'
FIPLIANCE
'
SIGNS , C. 1 e --- ,77,, , ,.. ( r,J40.9 1 / ' )
INSP. i5:7____ ROUGHINl �/(-9 -- i5:7____ SERVI g /` FINAL /- /L
EST. COST / a - PERMIT FEE sO" - DATE PD4 22041
REMARKS
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