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Home My WebLink About0028785-Electric (fire damage) � CITY OF OSHKOSH N° 28785 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC �PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS /�3 I,t-�%��L/� PLAN NO. OWNER �/ t//h 7H/ 162Y►Y1�A1 DESIGNER USE/NAT�RE OF WORK : 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 Electric Serv. New ❑ Change ❑ Temp ❑ Type 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 n � FEES: Valuatio � �� —Permit Fee Paid $ �C� Park Dedication $ '�— c' / ISSUED BY Date � �� —��al/O.P. �� _ In the performance of this w rk gree to perform all work pursuant to rules governing the described construction. SIGNATURE ��, �1= AGENT ER DATE - ADDRESS TELEPHONE# -