HomeMy WebLinkAbout0038507-Electric 6/z
CITY OF OSHKOSH N ° - 38507
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC% PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS c -5 PLAN NO.
OWNER �_,L�n ate'
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- ,..o- -i,thLt rGlrfl.�
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 $ O _ 0 0 Permit Fee Paid $ /, / 4Ci . Park Dedication $
ISSUED BY i 4 � „� Date Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
(O /
PERMIT NO. 3f50 7 . APPL . DATE i / 4
ELEC. CONTR. /G
OWNER �,g
ADDRESS S ?' o 1/
NATURE OF WORK coL. -�^
ELEC. SERV. NEW CHANGE TEMP .
DESC. TYPE VOLTS AMPS
FIX'S / SW'S RECEPT'S / CI RC ' S./
APPLIANCES
S IGNS
INSP . ROUGHIN /AD /4 y SERVICE _ FINAL
EST. COST 1/ • fD PERMIT FEE 10 f) d DATE PD . /t //9((
REMARKS