HomeMy WebLinkAbout0031832-Electric (repair) � CITY OF OSHKOSH N° 31832
`' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC �( PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS �/ � L.1_-r1!{� P �,�i� PLAN NO.
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 ❑ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR /�����%�����r � � 1--
.
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches�_ Receptacles�_ Circuits�_ ,/�
v
.
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
/ o �
FEES: Valuation $ � _— Permit Fee Paid $ < ��� Park Dedication $ ;
ISSUED BY Date�,� `! .Z Final/O.P. �i� ' �`/�-�
In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE �/Z—j �y�-
AG / NER DATE
ADDRESS
TELEPHONE�
€ � f � �/�
PERMIT NO. � ( �� �APPL. DATE � �'" ~�
ELEC. CONTR. � ��
r
OWNER � `��
ADDRESS / � �'� �'l/%�i'/°'L�'�-�'���l �
NATU�tE OF WORK
FT EC SERV NEW CHANGE TE1KP-
DES�. TY E VOLTS AMPS
FIX' S SW' S RECEPT' S CIRC' S �
APPLIANCES
SIGNS
INSP. ROUGH N SERVICE FINAL � � -i1
EST COST CG--� PERMIT FEF✓C� --- DATE PD✓,� -3-9.Z
REMARKS