HomeMy WebLinkAbout0023518-Electric 4.--) CITY OF OSHKOSH N°_ 23518
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC I LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / �,41 22 � PLAN NO.
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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 . (-4 " ------- 7 -
Electric Serv. New Change ❑ Temp ❑ TypeW Vol ° Amps / 4 " -c)
Fixtures V Switches [i 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 69 d P ermit Fee Paid $ SC-' ' ----- Park Dedication $
ISSUED BY Date 5 -aL `7/ Final /O.P. ! - off f -7/
In the performance of th' ork r ee to perform all work pursuant to rules governing the described construction.
,
SIGNATURE A ` '/ `" 3 ` !
AGENT /OWNER DATE -77
ADDRESS
TELEPHONE #
PERMIT NO. 3 S / T • APP . DATE "7 /-7-7 — /
ELEC. CONTR. C. /
OWNER
G /
ADDRESS oZ o
NATURE OF WORK ///%41
ELEC. SERV. NEW DS CHANGE TEMP.
DESC. TYPE . mann VOLTS /5- AMPS/
FIX'S P SW'S J' RECEPT'S 4 7( CIRC'S Oc
APPLIANCES V
SIGNS �e 4&
INSP. ROUGHIN O2 `� i SERVICE,9X- W-
�- 5 `// FINAL) 1
EST. COST ` .2oa ° - PERMIT FEE W DATE PD5 - 2”)
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