HomeMy WebLinkAbout0010114-Electric CITY OF OSHKOSH No 1
PERMIT - APPLICATION AND RECORD
TYPE: BLDG p HTG ❑ ELEC �LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 2 5 -f' _ PLAN NO.
OWNER ,
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
ELECTRIC CONTRACTOR _delte–e---..-- .--.6.4.---)
Electric Serv. New fhange ❑ Temp ❑ Type Volts Amps G� �-�
Fixtures Switches L.--- Receptacles v� Circuits L------
6 3:,C) r
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
P �
FEES: Valuation $ / ----- Permit Fee Paid $ C� Park Dedication $
ISSUED BY - _ Date o p vZ O Gs 4 — Final /O.P. X' -C-7 ir In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE �� d' Z6 40
AGENT /OWNER DATE
le
ADDRESS
TELEPHONE #
PERMIT NO. ` / , APP . DATE S _ 8 7
J
ELEC. CONTR.
OWNER - �
ADDRESS L ` 5 � 4
NATURE OF WORK
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ELEC. ELEC. SERV. NEW CHANGp TE
DESC. TYPE 3 - "-- - v -' VOLTS (z7- � AMPS'
FIX' S V SW' S e RECEPT p<,__ CXRC' S /C.
AP • LI S —,
1-47 �:i '
N P. ROUE , r'7 - iS0P4 ts0. - -/2 -t' F I - .'
ES . COST .fS roi% • _ RM _ 3 d ■D = - , : -)S
REMARKS
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