HomeMy WebLinkAbout0047516-Electric (temporary)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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N! ~ 47516
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ADDRESS /72.- 9' f~G~4p~ h
OWNER a~~~~
PLAN NO.
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Class of Const.
HEATING CONTRACTOR
~~
Heat 0 AlC D Vent D Fuel/System
Heat Loss
BTU'S
"
1
;:"ELECTRIC CONTRACTOR /~ ...
Electric Serv. New 0 Change 0 Tem~ Typelt/&. VOI1s~ AmP/fi
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft
_Lav _Sh _OW _OF
_WC _FOr _SP _Ur
_Sink _ L Tub _ Eject _SS
Other
_ CBasin
_ San. Sewer
FEES: Valuation $ 50. () <)
ISSUED BY 9,)).-
Permit Fee Paid $
Date
ItJ
_ Storm Sewer
_ Water
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 #
<7:.s:~ 1/)/3
~o I
PERMIT NO. 'fir 'lf7~/?" . . APPL. DATE
ELEC. CONTR. ~
OWNER r2n_~~
~DRESS /72-9 ';({~4~ a
~ATURE OF WORK
~~c. SERV.
D C. TYPE
FIX'S
_APPLIANCES
NEW J
l4/~
SW"S ~.
CHANGE
VOLTS .3 uJ
RECEPT'S
(~~ tJ
CIRe's
SI"GNS
NSP. ROUGH N
EST. COST :S-O
REMARKS
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SERVICE to FINAL
PERMIT FEE 0 DATE PD I 't ,r