HomeMy WebLinkAbout0010105-Electric 4-1) CITY OF OSHKOSH No 10105
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC [LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 76 / Z
DDRESS
PLAN NO.
OWNER
DESIGNER
USE /NATURE OF WORK
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 a
Electric Serv. New Change ❑ Temp ❑ Type Volts Amps Z 47--c)
Fixtures e.../"-- Switches [/ Receptacles � - Circuits /..----- ' AS c
/f
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 $ 0� Permit Fee Paid $ J.'"? ��c�Park Dedication $
ISSUED BY �� /a "°gam
Date Z– Final /O.P. 9 --- 348
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
-- Permit /&*(---1
..
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. !' C/ C 5 , APPL. DATE —��
ELEC. CONTR.
OWNER / P
ADDRESS l D — 9 -
NATURE OF WORK
ELEC. SERV. NEW C> CHANGE TEMP.
DESC. TYPE` J L _- — ¢J 4? VOLTS / 1 " �- st o AMPS D�
FIX' S 5 L RECEPT S °S CIRC' S AC
APPLIANCES
SIGNS /alp
INSP ROUGHIN W /'C- S 15 �q FINALS a�
EST. COST /.} d d PERMIT FEE 70 DATE PD.g-
REMARKS