HomeMy WebLinkAbout0040545-Electric
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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N~ 40545
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OWNER
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PLAN NOo
ADDRESS
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Class of Const.
I
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
"..
ELECTRIC CONTRACTOR ~.e~
+ Electric Servo New 6 Change 0 Temp J1(. Typeo!l..f VOlts2.ML. Amps ItriJ
Fixtures Switches Receptacles Circuits
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
i
FEES: Valuation $ / tJ cJ. Ou Permit Fee Paid $ ( o. c:'l 0
ISSUED BY ~~ ~~... Date 7 A,!9Y
Park Dedication $
Final/OoP.
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 #
6'+D
PERMIT NO.
ELEC. CONTR.
0.... I
OWNER P 9~ ~
. t' f/
ADDRESS 1.3 3 3 UI~~
NATURE OF WORK
SWIS
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CHANGE
VOLTS "3 (.A.l
RECEPT'S
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CIRC'S
EiEC. SERVo
D SC. TYPE
i:"IX'S
APPLIANCES
NEW
SI.GN S
INSP. ROUGHIN
EST. COST
REMARKS
SERVICE
PERMIT FEE
FINAL
DATE PD.