HomeMy WebLinkAbout0016829-Electric CITY OF OSHKOSH N9 16829
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC :ie PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
•
ADDRESS o2 0 30 4 PLAN NO.
OWNER / 1. 13 ct_pt
DESIGNER (,?
USE /NATURE OF WORK \ ,tkAJ -t&i
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 N L J- L LL
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures 'ice Switches ✓� Receptacles ✓� C ircuits f r
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 $ e -_ Permit Fee Paid $ J Park Dedication $
ISSUED BY ...JAI ii _.,,/ Date / — 3 – 7® Final /O.P. 2 3
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE (2.. 1^ 3- Po
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. I APPL• DATE / 2 7
ELEC. CONTR.
--2/-4
OWNER x;42 i" j&e 6aJ'2
ADDRESS �� 3 ,'-
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYP VOLTS AMPS
FIX'S (," SW' S PP$2PT' S CIRC' S
lie' ROUer `'- !a �,!' - - �M ���i� . - .•
• EST. COST /,''- -� PERMIT FEE 0 ' —DATE PD. / -5 'O ,
REMA?KS
Y
f