HomeMy WebLinkAbout0027646-Electric CITY OF OSHKOSH N° 27646
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS L '0 / So„fsd\,.. PLAN NO.
SS c
OWNER C 1 a �- /2
DESIGNER
USE /NATURE OF WORK r(� re/l ad . ,
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 k-SgG /a'
Electric Serv. New ❑ Change ❑. Temp 111 Type / Volts Amps
Fixtures Switches V Receptacles ✓ Circuits k-f fS)-
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 $ Qb.O' Permit Fee Paid $ /S -c �� -( 3 - 9 , -- Park Dedication
ISSUED BY Date 3 -(3 Final /O.P. /
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE �c S54- /
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #
PERM NO. - .APP . DATE - �-
ELEC. CONTR. /
7 4/
OWNER 427,4
ADDRESS
NATURE OF WORK G
ELEC. SERV. NEW CHANGE TEMP.
DEC. TYPE VOLTS FIX'S SW'S Gam_ RECEPT'S � CIRC'S
APPLIANCES
SIGNS
INSP. ROUCHIN :1 - 9'%2. - SERVICE FINAL 3�y A-
EST. COST eO = -- PERMIT FEE /5 - DATF
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