HomeMy WebLinkAbout0018025-Electric 1
1 CITY OF OSHKOSH No 18025
` 1 PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC [r. ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS o2 %7 PLAN NO.
iI
OWNER s•
DESIGNER
USE /NATURE OF WORK /
Y
j
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
u 1;
ELECTRIC CONTRACTOR
Electric Serv. Newt hange ❑ Temp ❑ T k 7 Volts 575Amps s-cJ 1)4:1'
Fixtures Switches Receptacles it...---- Circuits c_—
1 i
+t 1r
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC i FDr SP Ur Storm Sewer
Sink ‘i LTub Eject SS Water
Other °'
9
/ 1
FEES: Valuation $ 42 Permit Fee Paid $ 56' �^ Park Dedication $
ISSUED BY yt Date i7f —/ - ` p � Fi nal /O.P. I a • 3I - r/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
%kik / Il k ' / I
SIGNATURE !/ Al."- ‘,1 o
ENT /OWNER DATE
ADDRESS l'
ki TELEPHONE #
P_,FRMIT NO. i d = � APPL. DATE "I 7
1 '
ELEC. CONTR. 4,/
OWNER % 1� 12 �'•�
ADDRESS O — '
NATURE OF WORK A/247/
ELEC. SERV. NEW DS a CHANGE TEMP.
DESC. TYPE j--w v VOLTS t 4 o AMPS O .Da
FIX' S SW S RECEPT' S CIRC' S Off'
APPLIANCES 612-169
IGN j (1:
INSP. ROUGHI}T • -, SERVICE �( f0- 9� FIN
EST. COST ! Y& PERMIT FEE co DATE PD.* /7 -
REMARKS