HomeMy WebLinkAbout0025560-Electric CITY OF OSHKOSH N° 25560
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS t �. y . PLAN NO.
OWNER ' ' t i I i/
DESIGNER ;�]�
USE /NATURE OF WORK 1�� I7iv—
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 ‘Iji rz c t- ,4 0-A/-4--
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps C'119—
Fixtures Switches Receptacles Circuits
i'LUMBING 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 $ ' D v o '"�_Permit Fee Paid $ (-5 (-" q sae- � Park Dedication $
ISSUED BY .lit Date /e -/ -- t/ Final /O.P. / a- i ? - 9 /
In the performance of this . - I agr: , to perform all work pursuant to rules governing the described construction.
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SIGNATURE .4' _ ,.� L
AGENT /OW 0 DATE
ADDRESS
TELEPHONE #
PERMIT NO. APPL. DATE
ELEC. CONTR. G.�� t �L
OWNER ya 4 V- 0e4.4.41
ADDRESS /‘7 - 27 / I
NATURE OF WORK fh
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S Off_ SW' S c'._ RECEPT'S DL CIRC'S\
APPLIANCES
SIGNS
TNSP. ROUGHIN ®1'( -9 9 -1/ SERVICE FINALC3.J ij
EST. COST ma cot - PERMIT FEE 5 - 0 ==., DATE PDJQQ 1 -9/
REMARKS