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HomeMy WebLinkAbout0042805-Electric ~ ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD 62( 0-- .42805 N_ . ~P_E~ _ _ ~L~~ _~ _ ~T~ _ ~ _ ~~E?;r ~~B~ _ ~ _ ~I~~ _~ _ ~O_N~N~ _ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ ADDRESS blfs-r- :2yS-7 ~ (?r- OWNER ~~ DESIGNER PLAN NO. USE/NATURE OF WORK -- BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit HEATING CONTRACTOR Heat 0 AlC 0 Vent 0 FueVSystem Heat Loss BTU'S ELECTRIC CONTRACTOR Electric Serv. NewXChange Amps ZH Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR _BT _WH _Sh _FDr _ L Tub _Disp _DW _SP _ WSoft _DF _ CBasin _ San. Sewer _Lav _WC _Ur _ Storm Sewer _Sink Other _ Eject __SS _ Water Permit Fee Paid $ <- / (2r- j 6~.0 0 ///~ y/ Park Dedication $ Final/O.P. ISSUED BY ~ Date 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: # {pZ( . APPL. DATE I'/~;'Y CHANGE: VOLTS C4/ RECEPT' S TEMP . AMPS 0 CIRC'S 2- - I' J m~