HomeMy WebLinkAbout0001779-Electric (misc.) CITY OF OSHKOSH N2 01779
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC/ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 3 / V I Gi ff� PLAN NO.
OWNER 6 tdo i, Ar?-k: /9
DESIGNER
USE /NATUR • F WORK . ' i! 1 . r i f.. . 7.../ 7 . / 4 . '4
'/ .1 i , J. ►
— 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 . �/ /IC
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures iti Switches Receptacles 6 .,.. 7 N._ 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
p G .9 c.
FEES: Valuation $ �� Permit Fee Paid $ Park Dedication $
ISSUED B Date /O ' "7 7 Final /O.P.
In the performance of this work I agree to perform all •rk pursuant to rules governing the described construction.
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SIGNATURE �l i ,��( /�/ " �(..//
AGENT /OWNER 9 . E
ADDRESS
TELEPHONE #