HomeMy WebLinkAbout0017036-Electric CITY OF OSHKOSH N° 17036
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC L BG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS a f Z / `� j
PLAN NO.
OWNER , c�' 17
DESIGNER
USE /NATURE OF WORK
BJJILDING 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 , '
Electric Serv. New 0 hange ❑ Temp 111 Type Volts Amps -7
v'
F
qc 2________ _
ixtures — witches C.--- Receptacles t Circuits
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-- /
F '' �� co 5L G-
EES: Valuation $ rmit Fee Paid $
`�— Park Dedication $
ISSUED BY ///!4 &
/ ..
/ Date / — 7 � � / Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE / �Q
I ENT /OWNER
DATE
ADDRESS
TELEPHONE #
PE - _ T NO. " . = P . DAT // /.
• CONTR. —iii ,
OWNER � - A
ADDRESS D /
NATURE OF WORK
MAC. SERV. NEW c.K CHANGE TEMP.
DESC. TYP; 3-L4, v 4 VOLTS / L/" c AMPS 9 C
FIX'S SW' S L/ RECEPT' 8 CIRC' S sC'
i1fii/
SIGNS
• • Wei; N' i l� ER C c" - F
. • T ♦ RM F 4% . P•
REMARKS