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HomeMy WebLinkAbout0010851-Electric (temporary service) � CITY OF OSHKOSH No 10851 `' PERMIT — APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC,� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS 0 D � PLAN O. OWNER ' DESIGNER � USE/NATURE OF WORK BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit : HEATING CONTRACTOR Heat ❑ A/C ❑ Vent ❑ FueUSystem Heat Loss BTU'S , ELECTRIC CONTRACTOR Electric Serv. New ❑ Change ❑ Temp � Typ�� Volts� Amps �� 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 t'r r �•.�;� � - PER�RIT �-��—,�,�;-`=���� �y ite�ol�tinn �Z uf FEES: Valuation $ � Permit Fee Paid $ On 0J1,t1 CI � ��1 rk Dedication $ i- , ISSUED BY Date — G' � ��G� �Final%O.P. � `�Z—�� In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE - 'U-�f G•-��- AGENT/OWNER DATE ADDRESS �'"'°��� 1 /t�PIL�/� TELEPHONE N PERMIT NO. �� PL. DATE ���� �� ELEC. CONTR. OWNER ADDRESS �� D 2 -� NATURE OF WORK ELEC. SERV. NEW CHANGE TEMP. DESC. TYPE �3 - � �a VOLTS � �-° �+�d AMPS � � FIX'S SW'S RECEPT' � CIRC'S � APPLIANCES SIGNS INSP. ROUGHIN SERVIC - - Z~ INALG-�7-8� - EST_ COST SO � PER E PD. RBMARKS , arc ,�%