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HomeMy WebLinkAbout0022867-Electric CITY OF OSHKOSH N° 22867 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC g PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ADDRESS c 7 I © SI- egx N4 PLAN NO. OWNER 6 /4a ((' /'Ec /t C . DESIGNER USE /NATURE OF WORK t.-R'J'R E 4) Ec J 66(4_ 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 7LU -F/_S EG.EP Electric Serv. New Change ❑ Temp ❑ Type (A Z Volts /. 0 Amps Fixtures x Switches x Receptacles u Circuits X 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: Valuation $_ r O� � Permit Fee Paid $ ( J ✓ Park Dedication $ ISSUED BY mil. Date y — f Q c� — f / Final /O.P. ; TO )q, In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE .��. (�' 1 ;a1 y�g AGENT /OWNER A TE ADDRESS TELEPHONE # PERMIT NO. °2 716 , APPL. D • TE `.0 / L C. CONTR. OWNER ADDRESS � /D - F ` ' NATURE OF WORK , ELEC. SERV. NEW (' CHANGE TEMP. DESC. TYP ) � t - v � VOLTS !2 icd AMPS f OCR FIX'S SW'S JC RECEPT'S ,„� CIRC' APPLIANCES L SIGNS !/ .R' INSP. ROUGHIN b / {- ' /0 - r( SERVICE//'( - ) t1- iFINAL G 3O- EST. COST „,.._/ da % PERMIT FEE 8`.S' ATE PD. -9- / REMARKS