HomeMy WebLinkAboutElectric
~
1p("l/
N2- - 47200
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
~P_E~ - _~L~~ -~ _~T~_C?- ~~E~_rf ~~B~_C?- ~I~~ -~ _~~N~N~_~- _F~~~D_~~I~~- ~~I~~T~
ADDRESS to'5""") cd y~ ~ '
ðrh~
PLAN NO.
OWNER
DESIGNER
ß ~ ~--k/
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat D AJC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR Ó U/"Y¡.t/1
Electric Servo New 0 Change 0 Temp 0 Type - Volts - Amps
'"2... "~~~
Fixtures ì.---'" Switches .--....---- Receptacle. H;' ~ Circuits ~
PLUMBING CONTRACTOR
_BT _WH
_Lav
_Sh
_Disp _WSoft - CBasin
_DW _DF - San. Sewer
-SP _Ur - Storm Sewer
- Eject _SS _Water
_WC
_FDr
_LTub
_Sink
Other
/
(Í ./
Permit Fee Paid $ 0 .0<3
Date 9fÍd;/9 r r
Park Dedication $
FinaYO.P.
FEES: Valuation $ /00. 00
ISSUED BY ~.
v
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR'E'A 7YJ:æ J () f. J¿
AGENT/OWNER
t53 l' ') ;f fA- Hi/£:
9' /I.~ /95
DATE
V ;)t,~gf:<Æ
TELEPHDNE #
ADDRESS