HomeMy WebLinkAbout0043804-Electric (upgrade)
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CITY OF OSHKOSH N~ 43804
PERMIT - APPLICATION AND RECORD
~P.E~. .~L~~.C! .~T~.C? ~~E? J). ~~B~.C? ~I~~.C! .~O~~N~.~. .F~~~D.~~I~~. ~~I~~T~
ADDRESS
/3'-'W I <tv,- (J~
~44¥ (j ~/ZM)
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PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms # Stories Height
Class of Const. Occupancy Permit
Heat Loss BTU'S
Foundation
HEATING CONTRACTOR
t
Heat 0 AlC 0 Vent 0 Fuel/System
ElE~:::~c ~~:~RAC;~wR oWLge ~ Temp 0 TypeOUL VOlts~ Amps~
Fixtures Switches Receptacies Circuits
PLUMBING CONTRACTOR
_BT _WH
_lav
_WC
_Sh
_FDr
_Disp _WSoft - CBasin
_DW _DF - San. Sewer
_SP _Ur - Storm Sewer
_Eject _SS _Water
_Sink
Other
_LTub
ISSUED BY
3~.-.~ oj
Permit Fee Paid $ ~~ ,~
Date 'b/r crt? í
Park Dedication $
Final/O.P.
FEES: Valuation
In the performance of this work I agree to perform all work pursuant to rules governing the described construction,
SIGNATURE
DATE
AGENT/OWNER
ADDRESS
TELEPHONE.
9<' ;0
PERMIT NO. if?,f-ó y
ELEC. CO~TR. Mì
OWNER
1!/o!c¡X-
. APPL. DATE ¡¡;oÞ~
, (
C-,'I'
ADDRESS /3 -z. W I <ftt!:- á~
tTATURE OF WORK
ELEC. SERVo
DESC. TYPE
FIX'S
APPLIANCES
NEW
o/#-
SW"S
~ 'Z--"3 '"
VOLTS ..;IVt/
RECEPT'S
TEMP.
AMPS "Lda
CIRC'S
SIGNS
INSP. ROUGH N
EST. COST (þ 0
REMARKS
SERVICE I /. ~
PERMIT FEE .r
FIN IJ ~
DATE PD.2- ('f¡ ~