HomeMy WebLinkAbout0037514-Electric
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
N2
10 {I
37514
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ADDRESS
PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat 0 AlC D Vent D Fuel/System
Heat Loss
BTU'S
Electric Servo
\;lELECTRIC CONTRACTOR
New
Temp D
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT
_WH
_Sh
_ San. Sewer
_WC
_FDr
_ L Tub
_Disp
_DW
_SP
_ WSoft
_DF
_ CBasin
_Lav
_Ur
_ Storm Sewer
_Sink.
Other
_ Eject
_SS
_ Water
FEES: Valuation $ ,;J.t; 0 O. Q 0 Permit Fee Paid $
ISSUED BY ~'t-- ~ Date
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,
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
f~~-
AGENT/OWNER
---.
DATE
ADDRESS
TELEPHONE #
73( -i~9.9
PERMIT NO. 37'5"/'{ . APPL. DATE
ELEC. CONTR. J~~ I
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OWNER ~.I!t~.. ~~
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1I!3!q3
EiEC. SERVo
D SC. TYPE
FIX'S
APPLIANCES
NEW
. fA/~
SW'S '
CHANGE
VOLTS :> W
RECEPT'S
TEMP .
AMPS 2..<' c
CIRC'S
SIGNS
INSP. ROUGHIN
EST. COST
REMARKS
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SERVICE /'"1 FINAL
PERMIT FEE -:"-0,00 DATE PDI
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