HomeMy WebLinkAbout0047970-Electric
~
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
~(1.-
N~-47970
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ADDRESS I ! 7 () /?t~A../ A~
OWNER ~ ~
DESIGNER
PLAN NO.
USE/NATURE OF WORK
..
<<~ir~
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Class of Const.
HEATING CONTRACTOR
Heat D AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR a~ /?2'/7 ~~
Electric Servo New 0 Change 0 Temp 0
Type
Volts _ Amps_
Circuits
Fixtures
Switches
Receptacles
PLUMBING CONTRACTOR
_BT
_WH
_Sh
_FOr
_ L Tub
_Disp
_OW
_SP
_ WSoft
_OF
_ CBasin
_WC
_Ur
_ San. Sewer
_ Storm Sewer
_ Water
_Lav
_Sink
Other
_ Eject
_SS
FEES: Valuation $ ~. J) "
ISSUED BY 9-k-
V
I'
I.- . ;'
Permit Fee Paid $ . ~ .. d -0
Date /0/4,/9 ~/
{
Park Dedication $
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 #