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02692-Electric
~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 02692 TYPE: BLDG 0 HTG 0 ELEC ~ PLBG 0 SIGN 0 ZONING FLOOD PLAIN HEIGHT ::N::~ -/l!ff: - d2J~d~L~ ~ : - - - - - - - - ~~~ ~~- - - - - - - - - - - DESIGNER ~J~~, USE/NATURE OF WORK BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. HEATING CONTRACTOR Heat 0 AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR Fixtures New 0 Change 0 Temp 0 Type _ Volts _ Amps /6--d ./Z- Switches ~.. Receptacles /<-- Circuits x CI1J ~./~\ Electric Servo PLUMBING CONTRACTOR _BT _WH _Disp _ WSoft _ CBasin _Lav _Sh _DW _DF _ San. Sewer _WC _FDr _SP _Ur _ Storm Sewer _Sink _ L Tub _ Eject _SS _ Water Other / Permit Fee Paid $ 5 O'~ /' Park Dedication $ Date 1-;1-;z. -g7 Final/O.P. 3-/t:,-X7 ~. ISSUED BY In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE 9~ AGENT/OWNER /~ 7f7 / DATE /' ADDRESS TELEPHONE # ~~ ELEC. CONTR. OWNER ADDRESS NATURE 0]' WORK SIGNS INSP. ROUGHIN EST. COST .?'1 REMARKS