HomeMy WebLinkAbout0026727-Electric (temporary) CITY OF OSHKOSH N9 26727
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ; fin PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 2 S/a Si 6 / PLAN NO.
OWNER a/I /55 44iEs
DESIGNER I
USE /NATURE OF WORK ��(/ /;444'
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 S t
Electric Serv. New ❑ Change ❑ Temp,( Type Lf a VoltsS/ Amps 4 -0
6CL_____„
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
e.%' a u
FEES: Valuati.n $ A. Permit Permit Fee Paid $ ` Q `� c � �` Final /O.P.
Park Dedication $
ISSUED BY . % . Date / — / ! ?/ 42-
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNA URE c -7C1 .-----
�
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. e i APPL. DATE /D 27 7
ELEC. CONTR. l2 C,/
OWNER Cjt-iV1 s s
ADDRESS
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP .
DESC. TYPE .3 — k - — cJ VOLTS / "' AMPS 1
FIX'S SW' S RECEPT' S of CIRC' S lY'
APPLIANCES
,S�GN. 90'1
INSP . ROUGHIN SERVICE &,f -14 Z 7,91 FINAL /2 —/ 7.-?7
EST. COST �6� PERMIT FEE/0 / DATE PD -1r
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