HomeMy WebLinkAbout0019495-Electric (temporary)
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CITY OF OSHKOSH N~
PERMIT - APPLICATION AND RECORD
19495
TYPE:
BLDG D HTG D ELEC ~BG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
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OWNER
DESIGNER
~/
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR'
Heat D AlC D Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
d
~
T::; ~ TYpe~ vo~' Amps~
Receptacles 1><.._ Circuits ~
Fixtures
New D Change D
Switches
~
Electric Servo
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
Permit Fee Paid $
Date
/
/& c....;-'/
7-/Y-?L:'
Park Dedication $
~ -/;< ...?~
ISSUED BY
Final/O.P.
ee to perform all work pursuant to rules governing the described construction.
AGENT/OWNER
~7d~
/ DATE
SIGNATURE
ADDRESS
TELEPHONE #
PERMIT NO ~ I 9 ~ J? 5" . APPL. DA'l'E { -/ J -YO
=~ CONTR. j?~~
ADDRESS / V 7/- ~ ~ Wr"'~,~ "
, NATURE OF WORK ~
() !.:----'
CHANGE '
VOLTS f
RECEPT I
i
TEMP .
AMPS 0
CIRC I S ""-
C. SERVo
D__C. TYPE
FIX'S
APPLIANCES
SI'GNS
NSP. ROUGH N
EST. COST
REMARKS
NEW
,- l..v _ V
SW'S