HomeMy WebLinkAbout0022385-Electric (service) CITY OF OSHKOSH N°_ 22385
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC K PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS . r. 11,_ 441; 4 . Y: PLAN NO.
OWNER 26ad4.) k U Ya
DESIGNER
USE /NATURE OF WORK 8 V( 3 ZOO Q • O i hi.
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 CONTRACTO' . '/ J 1 L 6 _ e .
Electric Serv. New A Change ❑ Temp ❑ Typvw ' Volt)Amps 'F.-00 d . /-
Fixtures Switches 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
d G
FEES: Valuation $ // "� Permit Fee Paid $ ,C Q Park Dedication $
ISSUED BY Date 2 -- /9` . // Final /O.P.
In the performance of thi o I agree to perform all work purs • rules governing the described construction.
SIGNATURE ad/ ►0 ( T _ W 1
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO ) X/ , APPL . DATE o2 —// ` 9�
ELEC. CONTR. /
OWNER
ADDRESS - - ! /
NATURE OF WORK
ELEC. SERV. NEW k FP TEMP.
D _C . TYPE -- w ` e rf- VOLTS ! 4.0 ANTS C S ~
FZX'S SW'S p' RECEP 'S CIR
APPLIANCES
SIGNS SERVICE FINAL
(fit 0
EST . COST ROUGHIN PERMIT FEE , DATE PD r2- '5% EST.
REMARKS 4.,
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