HomeMy WebLinkAbout0043990-Electric �/z'
� CITY OF OSHKOSH
N° 43990
` PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS �v� � /�-�/��w� PLAN NO.
OWNER�.�.2���!'v ��1�L�.C�i
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 ���/1�
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
FEES: Valua' $ l� �� •0 � Permit Fee Paid $ SO. O � Park Dedication $
ISSUED BY ^ Date -3�3 9 J� Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER DATE
ADDRESS
TELEPHONE I