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HomeMy WebLinkAbout0022795-Electric /7 CITY OF OSHKOSH N° 22795 �" PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC � PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - rN - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS �� � �T. PLAN NO. OWNER �/ '�`7�"�SE� I,S L l��/�2 C.T� � DESIGNER USE/NATURE OF WORK ��E►� �K �L� 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 _c-- G�'1�'�/m �i'L G�� C�/Y✓i £�.,Iq;C/ Electric Serv. New„� Change ❑ Temp � Type� Volts � z�o Amps ZDO /oo�f/t 5�.� � Fixtures._.� Switches_ � Receptacles x Circuit� ( PLUMBING CONTRACTOR —BT _WH _Disp _WSoft _CBasin —Lav _Sh _DW _DF _San. Sewer �—WC _FDr _SP _Ur _Storm Sewer —Sink _LTub _Eject _SS _Water r Other [� 0 FEES: Valuation $ � J��� Permit Fee Paid $ ��'�� Park Dedication $ ISSUED BY Date `� _/ � Final/O.P._�"".� S— �/ In the performance of this work I agree to perform all work pursuant to rules governing the described constiuction. SIGNATURE 2 9 AGENT/OWNER TE ADDRESS ��£�� TELEPHONE# PERMIT NO. 2 �'��`-�o . APPL. DATE���`�� ELEC. CONTR. L^���� Ge'k OWNER � 9 ADDRESS � �� -' 1 NATURE OF WORK E EC. SERV. NEW CH GE TEMP. D SC. TYPE - �•.- � L VOLTS i'`'�`� AMPS 2oO FIX' S SW' S RECEPT S CIRC' S � APPLIANCES SIGNS � INSP. ROUGHI SERVIC� � h1 - FINAL � EST. COST `G�--�PERMIT FEE 5�- DATE PD. 2 �q REMARKS � � � �