HomeMy WebLinkAbout0041287-Electric (upgrade)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
03'1
N!-41287
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ADDRESS
PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Class of Const.
HEATING CONTRACTOR
f',
Heat 0 AlC D Vent D Fuel/System
Heat Loss
BTU'S
r ELECTRIC CONTRACTOR O~~
Electric Servo New D ChangeXTemp D Type~,t: vo,ts3W Amps~
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _OW _OF _ San. Sewer
_WC _FOr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
FEES, Valuat~ ~ 0 · 0 0 _ Permit Fee Paid $
ISSUED BY ~ !~L4.~ Date
j ~-~o/", /'
tAJ,hY'
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 #
~
PERMIT NO. . ·
ELEC. CONTR. ~y
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ATURE OF. WORK
. APPL.
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DATE lc,(zq/; Y
ELEC. SERVo NEW
DESC. TYPE C
FIX'S SWIS
APPLIANCES
o
TEMP. .,:
AMPS o--.~
CIRC'S
VOLTS
RECEPTIS
SI'GNS
INSP. ROUGHIN
EST. COST
REMARKS
SERVICE
40 PERMITFEE .::>
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