HomeMy WebLinkAbout0031822-Electric (repairs) � CITY OF OSHKOSH N°- 31822
`' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC [�PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS �UN NO.
OWNER � /�/L �-�- ���
DESIGNER
USE/NATURE OF WORK ��-i��_
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 C�NTRACT�R�.l)��z- � � �/�c T/Y `
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches—� Receptacles ,�- Circuits—�� :
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,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
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FEES: Valuation $ �� ' Permit Fee Paid $ �� Park Dedication $
ISSUED BY Date�/�-3 '�z- Final/O.P. �1 � �6 -` ! Z—
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE �� � �9�-
UOWNER DATE -
ADDRESS
TELEPHONE#
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PERMIT NO. . APP . DATE �- �
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NA OF WORK �
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�"�'^ SERV NEW CHANGE TEMP• �
; E VOLT � �
.j Firi�' S SW' S RECEPT' S !X---CIRC'S o�� �
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� REMAR_KS �
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