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HomeMy WebLinkAbout0033034-Electric � 6 � � CITY OF OSHKOSH N°- 33034 `' PERMIT - APPL�ICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - -G�. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS ��� PLAN NO. OWNER ��' DESIGNER USE/NATURE OF W�RK 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 Electric Serv. New �hange ❑ Temp ❑ Type!�•w� Volt �6 Amps`°"' Fixtures �'`'— Switches `�-Receptacles �'� Circuits�- Y 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 b�`��.S `/ � Final/O.P. �i��'`y,� In the performance of this work I a e to perform all work pursuant to rules governing the described construction. SIGNATURE �� �`�/� GENT/OWNER DATE � ADDRESS TELEPHONE# PERMIT NO. � / �� / • APPL. DATE � ( � `y/ ELEC. CONTR. ( il�t�y.h�= ��"Y2�� OWNER .�JZ�- ADDRESS vZ � l — �'`''�'�'�-'/� ' NATURE OF WORK EC. SERV. NEW CHANGE TEMP. D'?SC. TYPE �- u° — �' VOLTS �' >-�f'G AMPS n ' FIX' S ,�.< SW' S p� RECEPT' J� CIRC'S .�_ APPLIANCES � SI�GNS _ � �r " INSP. ROUGHIN � S ERVI CE G`' � J��S y F INAL `` EST. COST ��'�%c° . PERMIT FEE � i DATE PD. -" REMARKS