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HomeMy WebLinkAbout0004979-Electric (repair service) � PE _ CITY OF OSHKOSH N° 04979 RMIT APPLICATfON AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC BG ❑ SIGN � ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - -PL - - - - - - - - - - - - - - ADDRESS_ � f � � �,� �ar- �� �, AN NO. OWNER- � 7 j�y�• �� L "CS`l 1;�-1.�"� l` �'i� DESIGNER C USE/NATURE OF WORK_ � /f !� f L`� ;�� -E✓ `-• �: � � ,f: 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_ l3 � 1 c�� �--� ���'7� Electric Serv. New ❑ Change ❑ Temp � Type Volts Amps Fixtures Switches Receptacles Circuits ���/����'�f 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_ G� z" � FEES: Valuation $ � � Permit Fee Paid $ /� �� � park Dedication $ ISSUED BY Date ��7 '�,7 FinaVO.P. � l°�- ` g7 In the performance of this work I agree to perform all work pursuant to rules governing the described constiuction. , .. '� � ^, . SIGNATURE -� ��= �� �-ti��-�_._ � ��' �`� AGENT�OWNER � � DATE ADDRESS TELEPHONE# P�RMT7' NO.� � / ` � APPL. AT� � ��`- � _ ELEC. CONTR. GC-A r2� OW N E R �I,��_,���� � ---� ADDRESS �dl�-� /// • NATURE OF WORK ELEC. SERV. NEW CHAN • DESC. TYPE VOLTS AMPS FIX' S RECEPT' S CIRC' S APPLIANCES , /� SIGNS INSP. ROUGHIN v SERVI CE� � ' c��--2�-� FINA -��'" EXT COST �D� PERMIT FEE / DATE PD��r-�T REMARKS � f