HomeMy WebLinkAbout0034062-Electric
TYPE:
BLDG D
CITY OF OSHKOSH
PERMIT - AYLICATION AND RECORD
HTG D ELEC ~G D SIGN D ZONING FLOOD PLAIN
~//
N2 34062
~
HEIGHT
OWNER
Jt'~5-~~
911~. ~.
PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK
,. ~
a,t/~ ~
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
~ ELECTRIC CONTRACTOR Subv(2J'Jit\l\J LLecre2c..
. ElecbicSe",. ~ew~hange 0 Te~p 0 TYpe~ vo~ Amps~
Fixtures ~, Switches t:5 RecePtacle:~ Circuits ~
Q-.
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
ISSUED BY
Permit Fee Paid $
Date
8' S!!E" --,
5" -.,2'f -7 3
"
Park Dedication $
Final/O.P. t/. .,) t . fI3
,
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~o..x..Q
~V\~
\ AGENT/OWNER
s- I z- '-(' I ilf ~
DATE
ADDRESS
TELEPHONE #
PERMIT NO. g
ELEC. CONTR.
~b ~ APPL~- tf-~]
'I
OWNER" 9J;JL./:~~--:; _
~DRESS Jd.:zS-:fr~.~
NATURE OF WORK _u~
EC. SERV. NEW CHANGE
DESC. TYPE -f..<..,... VOLTS
FIX'S SW'S RECEPT S
APPLIANCES
SIGNS
INSP.
EST. COST
REMARKS