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HomeMy WebLinkAbout0042792-Electric ~ ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD (p Z/ N~- - 42792 ~P_E~ _ _ ~L~~ _~ _ ~T~ _ ~ _ ~~E?Jr ~~B~ _ C? _ ~I~~ _C? _ ~O_N~N~ _ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ ADDRESS d-'fS~ -~LfS"f ~~ ~r OWNER rbM~< ,X#7?'tL.Y' DESIGNER PLAN NO. USE/NATURE OF WORK ~ l' 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 ~ 0. r/ ,1'..uA f)~ Electric Servo New~. Change 0 Temp 0 Type Volt~ W AmpsZ-th) Fixtures ~itches ~ Receptacles ----- Circuits~ PLUMBING CONTRACTOR _BT _WH _Ur _ CBasin _ San. Sewer _ Storm Sewer _WC _Sh _FDr _ L Tub _Disp _DW _SP _ WSoft _DF _Lav _Sink Other _ Eject __SS _ Water FEES: Valuation $ 3000, 00 Permit Fee Paid $ ISSUED BY ~ ~,{~ Date ~ / Kr:.o 0 j 1112-3/9 JC' I / 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 DATE AGENT/OWNER ADDRESS TELEPHONE # PERMI'i!: NO. ~? 9 2-- . ~PL. DAT~ 11/'2r-,/Q Y ELEC. CONTR. t<f~ Mr OWNER .~. ' - e? S-(P Z S {p-z,( SW'S 'ttMP . AMPS CIRC'S ""2- -{ &l 0 mJ!~