HomeMy WebLinkAbout04008 - Electric (rewire house) 4•■;) CITY OF OSHKOSH N° 04008
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
,� �^ tip- PLAN NO.
ADDRESS ��� D
OWNER /
DESIGNER
USE/NATURE OF WORK - am - • ,-
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 f{% w`-
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Z'-----'' Switches G"-- Receptacles L----- Circuits '
111
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
/ d 4� /� � C ,
FEES: Valuation Q$ / L Permit Fee Paid $ "( -4'.
�{ Park Dedication $
ISSUED BY 1 i '7 Date /J --a2 —G' 7 Final/O.P. f—147/4 I7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.(>--:4-/::---e
SIGNATURE ..,/-/C, � ":( DATE
AGENT/OWNER
ADDRESS TELEPHONE#
APPL DATE // �" 7
, ,PERMIT N0. '
ELEC. CONTR. , ..A.:,,,
a i OWNER
ADDRESS G22■! / '327%^/ )44 `/
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX' S ' /, '' RECEPT' S CIRC' S {-
APPLIANCES
SIGNS
INSP. ROUGHI ' ' - ` lr SERVICE FINA i ,'�3�
EXT. COST 06 !..2---- PERMIT FEE c,, -DATE PD. ,--247
REMARKS