HomeMy WebLinkAbout0047378-Electric Co ll
CITY OF OSHKOSH N2 " 47378
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC
2ii(/ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 3/ 9 V 3 PLAN NO.
OWNER
DESIGNER
USE /NATURE OF WORK d/-e
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 (26-09
2.-- , -
Electric Serv. New Change ❑ Temp ❑ TypS4 Volts [J ) Amps L"_
Fixtures Switches Receptacles Circuits
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: zoo 7
EES: Valuation $ O 0 O Permit Fee Paid $ J O Park Dedication $
ISSUED BY 24--- _ Date / &A7 )e Final /O.P. II - it2' 6.5
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. r 7 3 7 t . APPL. DATE
E _ C ON - .
OWNER /L C?�
ADDRESS 4-
NATURE OF WORK
ELEC. SERV. 63Rie CHANGE TEMP.
DESC. TYPE /lllZ VOLTS T �) AMPS'L
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES
SIGNS
s_ -. -OUris I-1'4t R fs4 F _N=
PST. COST 1_0 0 :� PERMIT FEE S DATE PD. 6 9
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