HomeMy WebLinkAbout0011568-Electric CITY OF OSHKOSH
N2 1
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC R PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS wzis `%6,,,ip C'lI A PLAN NO.
OWNER ,9 2 . /9 fi
DESIGNER
USE /NATURE OF WORK a/
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent El Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR dor,i ..,'il , / ._' •
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Y Receptacles u Circuits 14
or
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 $ 7 . � O ''� Permit Fee Paid $ , 3.> Park Dedication $
ISSUED B4LZiarLyfft Date _ /. 2 – 9' 8 Final /O.P. / Tr
In the performance of this wo gree to perform all work pursuant to rules governing the described construction.
SIGNATURE 0 1/1 D?fre o J(/,`yr',rr G�� AGENT /OWN DA T E // •
ADDRESS
TELEPHONE #
l /
PERMIT NO. ! / 5-t APP . DATE_
ELEC. CONTR.
OWNER
9114 /
ADDRESS
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S S RECEPT'S CIRC'S 4
APPLIANCES
SIGNS
INSP. ROUGHINC9 - if SERVICE FINAL /2
EST. COST 7 5 v ._ - PERMIT FEE 3,y - DATE PD - 7-d
REMARKS