HomeMy WebLinkAbout0022909-Electric
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CITY OF OSHKOSH N~
PERMIT - APPLICATION AND RECORD
22909
TYPE:
BLDG D HTG D ELEC lJ-PLBG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
DESIGNER
PLAN NO.
ADDRESS
OWNER
USE/NATURE OF WORK
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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 Servo
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New [g-Change D Temp D Type _ Volts _ Amps ?~
L-Switches -- Receptacles -Circuits <"
~,
e
ELECTRIC CONTRACTOR
Fixtures
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
FEESo valuat;o~;;<.t90 ~ Pe,mll Fee Prod $
ISSUED BY ~ Date
/
'?5~
t-/ -( ;;2--7' /
Park Dedication $
Final/O.P.
o - 17 - 9 J
.. #
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
~-7/
/' DATE' /
ADDRESS
TELEPHONE #
~, ,. ~
PERMIT NO. ?- :J- f 0 '1 . APPL. DATE ~ - 'T - Zj/
:::~ CONTR. ? ~ .
ADDRESS / 7 'f ,";}- - #~ ~,
NATURE OF WORK Ii/i.!
ELEC. SERV. NEW l>s CHANGE
DESC. TYPE ~ .(..IV -- v" Of VOLTS I,d
E'IX I S SW' S RECEPT I
APPLIANCES
TEMP.
AMPS ?-OC/
CIRC'S