HomeMy WebLinkAbout0012363-Electric CITY OF OSHKOSH No 1
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS g / n-,ry PLAN NO.
OWNER /t1c)qL Mc,42'L
DESIGNER
USE /NATURE OF WORK rit )e4L.I?t.L
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 LS c I cV
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures X Switches Receptacles� Circuits
g)
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
c•-) /
FEES: Valuation $ / • • D U Permit Fee Paid $ 2 -0- - Park Dedication
ISSUED BY 4.,
• 7.1-1. Date / — 7 7 Final /O.P. (9
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 1 cc CIRC • 2-/s
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #
PERMIT NO. G'' . . APP . DATE
ELEC. CONTR.
OWNER ' " #
ADDRESS r0 3 -
NATURE OF WORK _ ,or ' �s 4.11111111119r_
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S p`-- SW' S - RECEPT' S A; CIRC' S 4'
APPLIANCES
SIGNS
INSP . ROUGHIN 2 - .Z - 77 SERVICE F INAL 6 77
EST. COST D 2 - PERMIT FEE ° =DATE PD -1 6 - If
REMARKS