HomeMy WebLinkAbout0015808-Electric CITY OF OSHKOSH
N2 1
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /3 /0 117 0 n (cx n c( PLAN NO.
_bi ll OWNER o _claw
DESIGNER
USE /NATURE OF WORK W f f e, F/'» to d S Pet)
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 40 ° h h 1
Electric Serv. New ❑ Change ❑ Temp ❑ Type ? ' Volts o Amps /•
, "15 : ::) .
Fixtures 1 --- - Switches L- Receptacles L— Circuits L ' - '
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 $ Permit Fee Paid $ �e Park Dedication $
ISSUED BY Date /Q'." / -- K % Final /O.P. 1/ Imo- 7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATU l k.
AGENT /OWNER /4//1
ATE
ADDRESS
TELEPHONE #
PERMIT NO. /7," . APPL. DATE /e —/
i
E C. CONTR. Ak.-.`!,.r,iLdcfe _
I, .9
OWNER / ` O
ADDRESS / .3 ` - , G -
NATURE OF WORK Zdil/.
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE 3 -- w ei4 VOLTS 79- ...%5 7 Ke AMPS Lea
FIX'S SW' S De-- RECEPIP S 25 CIRC' S lk
APPLIANCES V
SIGNS ` " (.C-�/
INSP. ROUGHIN OR- /ki 4 - 7q SERVICE eKsolfq FINAL / / -)fW
EST. COST 45 PERMIT kEE 5 z'_ — DATE PD /, /O -By'
REMARKS
r "