HomeMy WebLinkAbout010876 - electric (Wire addition ) CITY OF OSHKOSH No 10876
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECX PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS
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OWNER .--�-�"` o� �°wt.G...<-r
DESIGNER /
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USE/NATURE OF WORK �2~��z-� ��-`l �` '��'Z-
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
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ELECTRIC CONTRACTOR f
Electric Serv. New ❑ Change ❑ Temp Type Volts Amps
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Fixtures Switches k Receptacles L...\-/ Circuits X i
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
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FEES: Valuation $ 5--(' — Permit Fee Paid $ t �- Park Dedication $
ISSUED BY"/ ',/
oLe
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In the performance o this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATUR 'c'1----C9-1:1% __. g/ '-1/-CtS 'J
AGENT/'OWNER. l DATE
ADDRESS ( / a (,s7 - t. -e R-tO (�/ c 51-/5`0 5._
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