HomeMy WebLinkAbout0019497-Electric (temporary)
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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
19497
TYPE: BLDG D HTG D ELEC ~G D SIGN D ZONING
FLOOD PLAIN
HEIGHT
OWNER
/76S'--
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;2-
PLAN NO.
ADDRESS
DESIGNER
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 CONTRACTOR
,. Electric Servo New D Change D Temp ~Type~ Volt!:3-- (/
Fixtures Switches Receptacles 1><::.''--: . Circuits
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,.
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _OW _OF _ San. Sewer
_WC _FOr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
t!' A oe;..-
FEES: Valuation $ (,/ ~ ....---
ISSUED BY t:?1W.,.rtfl,~
t7'-
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Permit Fee Paid $ . t:f ~
Date 7..- / r - 7 a
Park Dedication $
Final/O.P. G -;;. tr-r ZJ
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~ '"' ~.... /- ~
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ADDRESS
TELEPHONE #
ADDRESS
NATURE OF WORK
J 91f 77- ,APPL. DATE ~ -;z.y-?2)
7d1~
/7~5--W .
PERMIT NO.
ELEC. CONTR.
OWNER
ELEC. SERVo
DESC. TYPE'
Fr2<: ' S
APPLIANCES
CHANGE
VOLTS I ~ 0
RECEPT'S'
'V
TEMP.
AMPS
CIRC'S
S I'GN S
INSP. ROUGHIN
EST. COST
REMARKS
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SERVICE
PERMIT FEE (~