HomeMy WebLinkAbout0019479-Electric (temporary) CITY OF OSHKOSH N° 19479
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC IPBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /,‘,,,./e �� �'�
PLAN NO.
OWNER _� ���'C �"'
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 re"
Electric Serv. New ❑ Change L -1 emp ❑ TypepV Volts 1 d Amp�s / e2 le
Fixtures Switches Receptacles Circuits "S
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
. 010d ff
FEES: Valuation $ Fe ?>- Permit Fee Paid $ Park Dedication $
ISSUED B y Date / 'il7 - /G e Final /O.P. Y —/8 — y�
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE '� � / 1. '6' ,
4T/OWNER DATE
ADDRESS
TELEPHONE #
'
PERMIT NO. . APP . DATE 77 '
E _ C. CONTR. /
OWNER
o"' 3l I -- !,a4tAL
t•DR S
N OF WOR
CHANGE TEMP
ERE. 0 i VOLTS 1 "-. AMPS O
• 14_47 E • u,• ,- CRC' S
F X'
SW ' S RECEPT'S ■
ANCES i
11111V iv ..r FIN• '��`
ROU H _ N SERVICE M ;I DATE ' D D. -1: •90
N - PERMIT FE - -..
COST � r C�
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