HomeMy WebLinkAbout0043096-Electric CITY OF OSHKOSH
N2 43096
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC �j PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 2- 7 Z S
PLAN NO.
OWNER /6�(;/a4e /t44
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 CONTRACTO'/- .1. ..--1 . I Jr .• ' __
Electric Serv. New ❑ Change ❑ Temp Type Volts Amps
Fixtures `'/Switches 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: Valuation $ (.-0'0 0 Permit Fee Paid $ /ree J "
Park Dedication $
ISSUED BY � I4 f 1^1' Date / "AY Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE .1.10 4
AGENT /OWNER
,rr _r /� `- ,/ _ , t r� DATE j
ADDRESS "1 �� S k €rj L� lT O S R F-OS h I,l� 1 4 11 4 ` ?"3 - 1Y 7
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