HomeMy WebLinkAbout0020033-Electric CITY OF OSHKOSH N°_ 20033
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC X PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS c 3 v AA d Li l C-(49 pc.. PLAN NO.
OWNER rd2F -. (] 12 u. 99/DL ..L
DESIGNER ,�/
USE /NATURE OF WORK /VT // 14) /7 S r W( 'P/ 4 t , 9
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C El Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR 4a ('_.� t ,, , 4
Electric Serv. New 10 Change ❑� Ill Type (./G Volts /�dAmps , t 4 d0
Fixtures Switches Receptacles `------- 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
pv L pv
FEES: Valuation $ Yee' 625:3-'
Fee Paid $ g �_ Park Dedication $
ISSUED BY Date —4.1- Gp 0 - GZ' Final /O.P. M ^ a p
- 10
In the performance of s wo I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE / 7 , f
AGENT /OW DA
ADDRESS
TELEPHONE #
PERMIT NO. O v . 3 PL. DATE 7 --c
ELEC. CONTR.
OWNER KL-e-., , 74 eseVa --------------
ADDRESS 07 73 D --
y NATURE OF WORK 1,
ELEC. SERV. NEW DS // CHANGE TEMP.
DESC. TYPE ,1 -''-' - (I4 VOLTS / '; �� -4 /0 AMPSe200
FIX'S O' SW' S DC RECEPT ,P5 CIRC' S At
APPLIANCES
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N • . - OU • =kin •••' i ERVI �■ - -- - •) F N 1G i -- Fe
EST. COST - Wee PERMIT FEE 8'S DATE PD.$ O
REMARKS
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