HomeMy WebLinkAbout0022919-Electric CITY OF OSHKOSH N° 22919
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC kit.- ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS •4:) ` 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
)da - I-- --------
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps M
Fixtures Switches Receptacles Circuits s-- r
1 - v
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 $ Permit Fee Paid $ �5 Park Dedication $
ISSUED BY 9" Date -fj Final /O.P. 7 -. s ue/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ./ �is�`iL 2.
AG _9, R DATE
ADDRESS
TELEPHONE #
PERMIT NO. ›- 9/7 APPL . DATE -7 /
0
ELEC. CONTR. /:
OWNER "�
�
ADDRESS Vd
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DFSC. TYPE VOLTS AMPS
FIX'S '>LSW' S 7-- RECEPT'S S�
APPLIANCES
SIGNS
INSP. ROUGHINOIK-" J � � + SERVICE FINAL ° 25
EST. COST �G� d 1 PERMIT FEE 7 DATE PD///
REMARKS l ��