HomeMy WebLinkAbout0030711-Electric CITY OF OSHKOSH N° 30711
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC [LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS °2� Git/L...% PLAN NO.
OWNER '
DESIGNER
USE /NATURE OF WORK f
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
N,
ELECTRIC CONTRACTOR 7. .- ( 2.--------7 °
Electric Serv. New [I ❑ Temp ❑ Type Volts Amps —
Fixtures `'' Switches c.,-- — Circuits °;1--
PLUMBING CONTRACTOR
- BT WH Disp — WSoft — CBasin
- Lay _ Sh _ DW DF San. Sewer
WC _ FDr SP — Ur Storm Sewer
Sink _ LTub Eject SS Water
Other
FEES: Valuation 0 G ` `� 1 � ^^d .�-- j
$ Permit Fee Paid $ ✓ Park Dedication $
ISSUED BY Date _ —1 C `/ Final /O.P. // 0/�'3
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
1 lb. IOW
Il k
SIGNATURE // '''' " 7
o } .E,, DATE
ADDRESS
or
TELEPHONE #
awn' NO. 3 7 ! APP . DATE 7 6 y�--
ELEC. CONTR. =
OWNER
ADDRESS ''
'NATURE OF WORK / /,, ��
ELsC. SERV. NEW CHANGE TEMP.
DESC. TYPE '-/ VOLTS / d AMPS /C
FIX' S O` - SW' S oC RECEPT'r -' CIRC' S
APPLIANCES L
SIGNS
"1
NP. 'OUei4 ER CE' "- FIN• -2'-
• S 1=`_ / i. 4110 4.44Pir. r I DA - D
REMARKS
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