HomeMy WebLinkAbout0047517-Electric
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
Co if
N!-47517
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ADDRESS
PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
A~.J~
BUILDING CONTRACTOR
..
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Fou(ldation
Class of Const.
I
HEATING CONTRACTOR
Heat 0 AlC D Vent D Fuel/System
Heat Loss
BTU'S
Electric Serv.
Temp D
Type
vo,t;3 vJ Amps"'"Lrl
ELECTRIC CONTRACTOR
Fixtures
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _OW _OF _ San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink __ L Tub _ Eject _SS _ Water
Other
FEES: Valuation $
ISSUED BY
Permit Fee Paid $
Date
/
3"i. . 0 '" ./'
10/ Cf /q J/'
I ,
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
AGENT/OWNER
DATE
ADDRESS
TELEPHONE #
10 1/1 %~
PERMIT NO. Y 7 s: I 7 . APPL. DATE
.
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ADDRESS ! 72-7 .#~~ 4~ }2J17
NATURE OF WORK t
~C. SERVo
C. TYPE
FIX'S
APPLIANCES
~~
~ -'$
CHANGE
VOLTS 3 I...A/
RECEPT' S
TEMP .
AMPS~
eIRC'S
SIGNS
INSP. ROUGH N
EST. COST ,() D P
REMARKS
SERVICE
PERMIT FEE ~
) FINAL
DATE PD.;o 'i ~~.r