HomeMy WebLinkAbout0016175-Electric (temporary) 41.) _CITY OF OSHKOSH N2 16175
PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS °2 P `�7 0ie PLAN NO.
OWNER `���i��tol'
DESIGNER 9 'r
USE /NATURE OF WORK lb w - 6-t"`�
"
a�
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 :,-ef.----c-7-
Electric Serv. New ❑ Change ❑ Temp (11----- v Type ) Volts 1 'g Amps 6a
Fixtures Switches Receptacles Circuits V- 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 $ 3 .1------ Permit Fee Paid $ ` - 0
Park Dedication $
ISSUED BY Date //" —8. Final /O.P. /':' -5 - Y7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE / s' -e ?� �-'Z /% / //
/ �� T /OWNER
DATE
ADDRESS
TELEPHONE #
PERMIT NO . /‘ ! 7..5 . APPL . 'ATE
. ONTR.
OWNER
ADDRESS c7Z (— 2 ' l '
NATURE OF WORK
ERV. NEW CHANGE TEMP_ l�S
DESC. TYPE �-`�' — VOLTS / 3 ' AMPS 3 �'
FIX'S SW'S RECEPT' ' oC CIRC'S
APPLIANCES V
/) '
IIN PT. ROU IN BERM CE coK4 o —. ' -y9 FINAL /'
EST COST 5'i > PERMIT FEE DATE PD11 —A 8f
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