HomeMy WebLinkAbout0035971-Electric
~
N2
6o/()
35971
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
TYPE:
BLDG 0 HTG 0 ELEC ~BG 0 SIGN 0 ZONING
FLOOD PLAIN
HEIGHT
ADDRESS /69/
OWNER ~
DESIGNE~
~?,-zp~
~r'
~~
4&.
PLAN NO.
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
t
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR ~ .
Electric Servo New ~hange 0 Temp 0 Type_ Volts_
Fixtures V-Switches ~eptacles ~ Circuits
Amps~ '
a...---
PLUMBING CONTRACTOR
_WC
_FDr
_ LTub
_Disp
_DW
_SP
I
_ WSoft
_DF
_ CBasin
_BT
_WH
_Sh
_ San. Sewer
_Lav
_Ur
_ Storm Sewer
_Sink
Other
_ Eject
_SS
_ Water
/
,/
FEES, Valuation $ ;;. :!>O~rmit Fee Paid $
ISSUED BY ~ Date
?,~t e 0
'1f~ft3
Park Dedication $
Final/O.P.
In the performance of this wo agree to perform all work pursuant to rules governing the described construction.
~ ,/
SIGNATURE ,_a,/L-~_ 0/ /6' <- r7
DATE
ADDRESS
TELEPHONE #
PERMIT NO. ..r~<",q 7/
ELEC. CO~TR. ,~ /7
OWNER.~~/3~
ADDRESS /6"1/ #1Z:WA-- ~
NATURE OF WORK ~ #~
. APPL. DATE
,
Ffo,/ei ~
E EC. SERVo
DE C. TYPE
FIX'S SW'S
APPLIANCES
TEMP.
AMPS ~o
CIRe's
SI"GNS
INSP. ROUGHIN SERVICE
EST. COST ~ PERMIT FEE
REMARKS
FINAL
DATE PO. c . ~ .