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HomeMy WebLinkAbout0005174-Electric � CITY OF OSHKOSH N° 05174 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ' - - - - - - - - - - - - - - �/`� - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS a°3`�� '� �"-'� �"� PLAN NO. OWNER DESIGNER USE/NATURE OF WORK s!�«"'`J BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit HEATING CONTRACTOR Heat ❑ A/C ❑ Vent ❑ Fuel/5ystem Heat Loss BTU'S , . ELECTRIC CONTRACTOR Electric Serv. New [�Change ❑ Temp ❑ Ty�� Volts ��v`�Amps�"-`� ' Fixtures t'' Switches Y 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 �9 7 � U / a U FEES: Valuation $ ��-�/� Permit Fee Paid $ l ��-� Park Dedication $ ISSUED BY Date U � / `O '� Final/O.P. �-J p � In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE �L�� ' AGE DATE ADDRESS TELEPHONE# . PERMIT NO. � S � C / ► , AppL. DATE '-� -� ELEC. CONTR. . Q � OWNER � ADDRESS � �s/� -� j/ � NATURE OF WORK .�.� �L ELEC. SERV. NEW CHANGE TENIP. DESC. TYPE - L�- L VOLTS l� � d AMPS O G FIX' S W'S RECEPT' CIRC'S APPLIANCES SIGNS INSP. ROUGHIN� � i -� SERVICED � - - FINAL ' -3` EST. COST � PERMIT FEE ATE PD 'J-7- REMARKS � � �