HomeMy WebLinkAbout0009317-Electric CITY OF OSHKOSH N2 09317
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC 'PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS . u) 3 - sc<orritiec PLAN NO.
OWNER hi/ Y 041
DESIGNER
USE /NATURE OF WORK
6/126
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
f
ELECTRIC CONTRACTOR ' , 1 / At - ' A " c
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches X Receptacles Circuits
`Ag e
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
�q C� v 0
'
FEES: Valuafon $ ii 1 0 ® Permit Fee Paid $ �/� Park Dedication $
ISSUED BY / /"' - � �� 7 - � Date < — / 5 Final /O.P. -- �_
In the performance of this w agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ���� 941) S O
AGEN /OWN DATE
ADDRESS
TELEPHONE #
PERMIT NO. C/ /) / PL . ' ATE 5 — .2- 7
ELEC. CONTR.
j
t
OWNER ko-e-,6 ADDRESS �i -
NATURE OF WORK
ELEC. $ERV. NEW CHANGE TEMP.
DESC. E VOLTS AMPS
FIX'S TX 56/ D` RECEPT' S CIRC' S
APPLIANCES
SIGNS
INyP. ROUGH?R d c SERVICE e 4 F INAL -� $�
EST. COST oC 0 C� - �� PERMIT FEE 5 DATE PD.7-!5"
-
REMARKS