HomeMy WebLinkAbout0039402-Electric (correct code violations) �3s' ��--
CITY OF OSHKOSH N° 39402
� PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ;
ADDRESS ��� �• ��<<t i�w PLAN NO.
OWNER ��'�" �.t_,!./G�.�/Z/
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
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HEATING CONTRACTOR
i
Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR � u`z'-�
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures „� Switches ,�� Receptacles i 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: Valuation $ �d" �7•�� Permit Fee Paid $ S�•O c� Park Dedication $
ISSUED BY Date S�2'��,�— 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#
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PERMIT NO. � �O Z . APPL. DATE S�Z'�� 5`
ELEC. CONTR. LfJc��./.�.e
OWNER /57� ,��
ADDKESS �r�o 4�- C�'v�
NATURE OF WORK ('a�(p ��t�c�C���A_�
ELE�. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX' S SW'S RECEPT'S CIRC'S
APPLIANCES
S I�GNS �
INSP. ROUGH N SERVICE FINAL
EST. COST PERMIT FEE D. r� DATE PD. �
REMARKS ' Z
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