HomeMy WebLinkAbout0006652-Electric (temporary) CITY OF OSHKOSH N° 06652
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC [PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS o ?1-2- - e
PLAN NO.
OWNER v
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
O
Electric Serv. New ❑ Change ❑ Temp 141- Type l U Volts Amps
Fixtures Switches Receptacles P k) Circuits IC
A
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 $
S te- 1
Permit Fee Paid $ L `"`-�_ Park Dedication $
ISSUED BY .44d , __,,s Date 42 — ..›...7- -- 7 7 Final /O.P. / —1 / — Y7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction. IV- ,
SIGNATURE A Q/LC(-- -� /Z Z d'
/ • /OWNER AT
DATE
ADDRESS
TELEPHONE #
PERMIT NO, C/
DT
ELEC. CONTR. d
OWNER 0i WP
ADDRESS 2 3' ' - Gr ✓2�
NATURE OF WORK
ELEC. SERV. NEW
CHANGE ` TEMP . A."" 14.•' v
DESC. TYPE 7 - � - 4- VOLTS , 2 AMPS 4' "'
FIX'S RECEPS . " CIRC'
APPLIANCES v
S
PNSP . ROUGHIN - --- - SERVICF� /z � F INAL/2 6
EST. COST Yd / PERMIT FEE s-,c ° DATE PD/-Z
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