HomeMy WebLinkAbout0030696-Electric CITY OF OSHKOSH N9 30696
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ -PLBG ❑ SIGN p ZONING FLOOD PLAIN HEIGHT
Z ..5-6.� V ►/
ADDRESS 1 PLAN NO.
OWNER
DESIGNER
USE /NATURE OF WORK 5.V+`
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 0 -e----- "7 1:7
Electric Serv. New Eange ❑ Temp ❑ Type Volts Amps "0-r)
a
Fixtures v Switches ' ptacles `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
a 6. Ov
FEES: Valuation $ 50 0 Permit Fee Paid $ � Park Dedication $
ISSUED BY . / - �J' / Date / - / ( 7 Final /O.P. //� j /a /9
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE r / / t _ -
j r AGEN ER DATE
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ADDRESS
TELEPHONE #
PERMIT NO. / 6 . APPL. DATE 7 '-- - f -.,
E EC. ONTR. - _.,.. ,-Z-
OWNER 0
ADDRESS - 5 6 S`, / -/
NATURE OF WORK /!/ G /
MEC. SERV. NEW OS CHANGE TEMP.
DESC. TYPE 3 -- w - v.& VOLTS l AMPS /o 0
F X' ■ SW'S RE PT'S • CRC'S
APPLIANCES v
;G / s
�3NS / ' '�' `'
S I
INSP. ROUGHINd'Y - 8'''.JJ.'9.2- SERVICE6K-- 7 4 -PINAL /'- /af/
EST . COST Q 2 S 0 PERMIT FEE SY • DATE PD.7- 1 /'
REMARKS
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