HomeMy WebLinkAbout0016177-Electric CITY OF OSHKOSH N°_ 16177
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC E''PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 7r3s - �� e-�__ --2-cti PLAN NO.
OWNER
DESIGNER
USE /NATURE OF WORK _ '�" 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
0_,________ •
ELECTRIC CONTRACTOR
Z d°v --- / L c L ylo
Electric Serv. New ill/Change ❑ Temp ❑ Type Volts Amps '9Q"-
Fixtures 1 - - S - witches 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
FEES: Valuation $ , od
/ Permit Fee Paid $ // G� Park Dedication $
/
ISSUED BY i —I Date l < ''' - ' / Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
, /1111. lb,
SIGNATURE / / `�.�. //A-F
/ eht; -41 rnWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. /'/' 77 • APPL • DATE Z. ) U "EY
ELEC. CONTR.
OWNER r
ADDRESS 7-- r5 Y-
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP•
DESC. TYPE 3 w - vQ VOLTS l d AMPS Z-° a
FIX'S DC
SW ' S �� RECEPT'$ CIRC'S D4_
APPLIANCES / •r <
j
SIGNS
;NSP. ROUGHIN / ' 3_ ' SERVICE trk: D ° 91FINAL
EST. COST /2ael - PERMIT FEE O DATE PDIJ - -
REMARKS