HomeMy WebLinkAbout0009541-Electric CITY OF OSHKOSH N9 09541
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ H TG ❑ ELECA PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS 3 ,5 /Y / a —�c-�_ PLAN NO.
OWNER �-�i
DESIGNER {'
USE /NATURE OF WORK
BUILDING CONTRACTOR
Size F, "' 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 1.1 ) _-.-
Electric Serv. New ❑ Change El T p ❑ Type Volts Amps
Fixtures K Switches X Receptacles Circuits Oc al
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC j A FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
C'
FEES: Valuation $ I' O O ' ermit Fee Paid $ < J� Park Dedication $
ISSUED BY raleld�i D ate
— j �� � 7 ��7 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE #, 29 , i
AGEN D. E
ADDRESS
TELEPHONE #
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PERMIT NO.(' 94 / APPL. DATE 7 71-1140--- 7 -7 r -
ELEC.
CONTR.
OWNER ( P� C
ADDRESS
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S DCSW' S £ - - RECEPT' S C'
APPLIANCES
SINS
INSP. ROUG?IN , _ SERVICE FINAL
EST. COST if!) 4WD - PERMIT FEEJ %" DA'IE PD7 27-K8
REMARKS