HomeMy WebLinkAbout0005954-Electric CITY OF OSHKOSH N2 05954
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC 'PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS v , 1 4Ad / / " PLAN NO.
OWNER 4i - - 0 " .�
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DESIGNER
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USE /NATURE OF WORK III ' • `!lah. ,,..:&..4
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
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ELECTRIC CONTRACTOR
Electric Serv. New �hange ❑ T p ❑ Type Volts Amps
Fixtures Switches Receptacles - Circuits <------ ‘PiC------
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
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FEES: Valuation $ Permit Fee Paid $ / C Park Dedication $
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ISSUED BY Date O --,1e- i 7 Final /O.P. /
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE � /D-261-g7
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. (/ ✓ 3 , APPL . DAT !
ELEC. CONTR.
OWNER / f /Y`�'�,
ADDRESS l // F -
NATURE OF WORK ry , , � ?m -a
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
F IX'S CE b S .RECEPT' S � CIRC' S
SIGNS
SP. ROUGH 4'4b, `Y SER CE FINAL
EST. COST /,4/0/' •ERMIT FEE - DATE PD /4 ,2d -g7
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