HomeMy WebLinkAbout0017038-Electric CITY OF OSHKOSH N2 17038
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC BG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS �! PLAN NO.
OWNER / Q C, „d"-2,-.7:
DESIGNER
USE /NATURE OF WORK 7 '---------'
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 -1 �`' c. --1
Electric Serv. New Change ❑ Temp ❑ Type Volts Amps
411111\
Fixtures ■ Switches v Receptacles c_--. Circuits nip"
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
L V
U
FEES: Valuatio $ / Permit Fee Paid $ . 5-4 .- -/----- Park Dedication $
ISSUED BY 1_/_ 1._ 1 «.r'.,r Date / `/ L Final /O.P. 5 -4 . - 7 (7
In the performance of this work agree to perform all work pursuant to rules governing the described construction.
• /
SIGNATURE / , P
WNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. o ) APPL . DAT /f
Ir
ELEC. CONTR. / —
OWN _ ' /ice /.�i!' o�
ADDRESS / – !' /
NATURE OF WORK
ZLEC. SERV. NEW )L CHANGE TEMP.
• ' Dior _ — u, — v V• _ / 1-C ' AMPS /UU
FIX'S / SW ' S AL RECEPT' CIRC'S )'
APPLIANCES
SIGNS fro ,..,.
N • . ROUei; • - I -' R - •� / - f 0 - F" FI
EST. COST "PERMIT FEE Z f---DATE PD./- 7'
REMARKS