HomeMy WebLinkAbout0024679-Electric (kitchen) 41) CITY OF OSHKOSH N° 24679
PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / / 3 / ( �' SO.4 .S t. PLAN NO.
OWNER r; PS t /1- / /1( L 1 / te v q „i Z Gi is t Z
DESIGNER /' , y c
USE /NATURE OF WORK < <` 7 'C IeH /`/� C 1. S LJ1 /
Ta i-t
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 Al I I' 4G 7 -L 4. Co $96'
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps 6:--)
Fixtures Z- ----. Switches lam_ 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: Valuati $ Permit Fee Paid $ .Z.05-5-'j Park Dedication $
ISSUED BY
Date 617 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE t / OWNER A
DATE
ADDRESS
TELEPHONE #
PERMIT NO. 2 114 , APPL . DATE
ELEC. CONTR.
OWNER
ADDRESS d / 3 --
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S D`__ RECEPT'S °� CIRC'S
APPLI S
SIGNS
INSP. ROUGHIN SERVICE FINAL
EST. COST 3f0� PERMIT FEE 2 " %DATE De -7 17
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