HomeMy WebLinkAbout0012245-Electric CITY OF OSHKOSH N2 12245
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS 4 D 19 J(O - - _ % L PLAN NO.
OWNER U S
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DESIGNER
USE /NATURE OF WORK d- C l �,L
I 0 r at O kL `tlk U w t 7 L g lG k 1 °
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 ‘-o(a V' tear
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
) ,
Fixtures o-- Switches Receptacles ff— Circuits 4 '' --
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
/
5 6
FEES: Valuation $ 49 " G c Permit Fee Paid $ /2 f ------ Park Dedication $ i
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ISSUED BY Date / Y/ 7 Final /O.P. -�/°0 7p
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ' ; e //5/
AGENT /OWNER
/ DA
ADDRESS
TELEPHONE #
PERMIT NO. ` , APPL. DATE /
- 7 - ��
ELEC. CONTR.
OWNER /�% c„,e".1=7,
ADDRESS /oZ., /
NATURE OF WORK
ELEC. SERV. NEW CHANGE
DESC. TYPE VOLTS AMPS
APPLIANCES SW'S / RECEPT'S OL CIRC'S
SIGNS
INSP. ROUGHIN9/C--0,0-li SERVICE
EST. COST Wes, o
s va `' PERMIT FEE ' T INAL S - J/ - gy
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REMARKS - -DATE PD.j'j / -gJ
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