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HomeMy WebLinkAbout0015071-Electric ~' ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 15071 TYPE: BLDG 0 HTG 0 ELEC ~ SIGN 0 ZONING FLOOD PLAIN HEIGHT , , - - !- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - i- - - - - - - - - - - - - - - - - - - - - - - - " - - - - - ADDRESS / f?-<;.5 d ,.. c- t- t)l V' d ).. ~ I"L y::' ~eo ~ro A p",~b PLAN NO. OWNER DESIGNER USE/NATURE OF WORK -f ~Pv\.. ;J <() ,e> ~ BUI,LDING CONTRACTOR , Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class Q Const. HE),\TING CONTRACTOR Heat 0 NC 0 Vent 0 Fuel/System i Heat Loss i i BTU'S Fixtures ~/6l tr I New 0 Change 0 Temp ~ype1;tt Switches Receptacles Volts ~ Amps ~ ELECTRIC CONTRACTOR Circuits fi2, , Electric Servo PLUMBING CONTRACTOR ,. _Lav _WH _Sh _Disp _ WSoft _ CBasin _DW -dF _ San. Sewer _SP _Ur _ Storm Sewer i _ Eject _~S _ Water ~BT ,,_WC _Sink Oth,er i _FDr _ L Tub ~~ ' "c- Permit Fee Paid $ /q .-' Date f:T -;-;:;.-::z -V9 Park Dedication $ Final/O.P. S -? -F':9 ~ 0& FE~S' ValuaUon ~ :::----- IS~UED BY ~l i In ~he performance of this work I agree to perform all work pursuant to ~ules governing the described construction. !~ ~ SIG.""""NATURC< ;7 f -.,. - ! V' P AGENT/OWNER A~R~ , ~~/cf'3 ' DATE / / TELEPHONE # PERMIT NO. / ) " ~. . APPL. DATE ;;- < g---g;:? ELEC. CONTR. ~ ~ -~/'~ /YY5-'~/!~~ OWNER ADDRESS NATURE OF WORK . '- I-l.- ~ v CHANGE VOLTS "'f' CJ RECEPT IS V V SWIS TEMP . AMPS /' c CIRC I S tX'"' NEW r S INSP. ROUGH N EST.' COST 1-cJ~ REMARKS