HomeMy WebLinkAbout0020020-Electric CITY OF OSHKOSH N° 20020
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ItPLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / (90 "— -^g- LJ PLAN NO.
OWNER (.f )Y
DESIGNER
r Fs
USE /NATURE OF WORK /../t- .,60
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 VA L L G 'r CI �: c 71C i C 5 6 v I c L
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps ' lb,
Fixtures —Switches veptacles Circuits L K . i ■ 1
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
O
FEES: Valuation $ _5 0� G Permit Fee Paid $ sh e � � -�"�- Park Dedication $ /
SSUED BY / • • A6 ,l Dater / , Final /O.P. / l 90
the performance of this work I agree to perform all work pursuant to rules governing the described construction.
I ATURE Pae.....0...e.ei
#-/ 7_ 9a
AGENT /OWNER DATE
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TELEPHONE #
PEAMIT NO e?..119 APPL . DATE
7
OWNER
ADDRESS a-ea
NATURE OF WORK ( t3471.440 ELEC. SERV. .STEW CHANGE TEMP
DESC. TYPE VOLTS AMPS
FIX'S P SW'S ( RECEPT'S CIRC'S
APPLIANCES
SIGNS FINAL "� i YD
INSP . ROUGHIN Ou - - 15 ' (7 - 10 SERVICE
EST. COST 2 5 PERMIT FEE S5 DATE PD '/ 7 -W
REMARKS