HomeMy WebLinkAbout0030712-Electric CITY OF OSHKOSH N° 30712
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC [35.--1 ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS °2 / //-1-Ja' i
� PLAN NO.
OWNER E `
DESIGNER
USE /NATURE OF WORK '
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 ,)
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps /d —
Fixtures v Switches L Receptacles 4-- Circuits '/ 4"D'--
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
d S e V
FEES: Valuation $ .Z e - Permit Fee Paid $ e Park Dedication $
,���
ISSUED BY ;69��" Date ` " v 9 naI /O.P. Q " 9c ?
In the performance of this work I agree to perform all work pursuant to rules governing the described construction. N.,- ' 7—."71e,_
SIGNATURE A , �'�/ )......„4.63,,,w i/O _ R DATE
d or o fr, ADDRESS
TELEPHONE #
PERMIT NO. 3 O ` ` . APPL. DAT
ELEC. CONTR. r.dc_w�
OWNER 01, .
ADDRESS 2 )' / — GCS LG�a�G
NATURE OF WORK /61#
ELEC. SERV. NEW o< glANGE TEMP.
*4- - - w ✓ , VO i 3 yv AMP la c }
FIX'S SW' S RECE - S CIRC' S r'
; APPLIANCES
SIGNS / .rr
INSP. ROUGHIN ") — SERVICE C ),-} II FINAL �f'
$ PD.?--
EST. COST Ara U J PERMIT FEE , - — DATE i - -
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