HomeMy WebLinkAbout0022272-Electric CITY OF OSHKOSH N° 22272
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS � 1-10 c,v7-6. - ; A6'" � PLAN NO.
OWNER ear
DESIGNER
USE /NATURE OF WORK `�.--i-- re
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 r
Electric Serv. New ❑ Vange ❑ Temp ❑ Type Volts Amps
Fixtures 2\-- Switches i2C Receptacles �--__ Circuits (--._ 29--
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 $:1 �
dF u Permit Fee Paid $ }f- =ir/ � Park Dedication $
ISSUED BY � 1 ../.v %.I Date AW Y9' Final /O.P. Slielgi
c
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE LP I_ P / t" AF 7
AGENT /OWNER DATE ��i
ADDRESS / 7 ii• - # 2.40--a. 7 3 3 w
C� /� tI / TELEPHONE #
PERMIT NO. 7- 2 -- APPL . DATE /
ELEC. CONTR. •
OWNER
i
Q !y
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
D ESC . TYPE VOLTS AMPS
FIX'S !^ SW'S RECEPT'S CIRC'S
APPLIANCES —
SIGNS
INSP . ROUGHIN,,, SERVICE FINALS -4 i/
EST. COST l(J PERMIT FEE 1G' U' DATE PD 17,2 1 147
REMARKS
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