HomeMy WebLinkAbout0042175-Electric (addition & kitchen)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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42175
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ADDRESS
PLAN NO.
OWNER
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
ELECTRIC CONTRACTOR ~~ cz:. 1 ~
r
Electric Servo New D Change 0 Temp 0 Type_ Volts_ Amps_
Fixtures Switches Receptacles --- Circuits
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _LTub _ Eject _SS _ Water
Other
Permit Fee Paid $
Date
/
3r.o-o J
/4Jj; ~h ~
Park Dedication $
Final/O.P.
ISSUED BY
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 #
?
A
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6Jp
PERMIT NO. C(i;7 r
ELE~. CONTR. #~
,
OWNER ~r~
ADDRESS I /3 z.., ~~./
NATURE OF' WORK fir
ELEC. SERVo NEW ~ ~~~NGi)
DESC. TYPE VOLTS
FIX'S SW'S RECEPT'S
APPLIANCES
. APPL. DATE ..s~ 11 y
,
TEMP.
AMPS
CIRC'S
SI"GNS
INSP. ROUGHIN
EST. COST s-z.. . " ~-
~KS
('
SERVICE
PERMIT FEE 3 S;
FINAL
DATE PD.lo (
~ER~IT NO.
ELEC.
-' APPL. DATE
OwNER /~
ADDRESS /J)2- ~
:TURE OF WORK /Y'>1.3t. ~.
E~C. SERVo N~ CHANGE
D C. T~E ~L~
FIX'S SW'S RECEPT'S
APPLIANCES
~:~ RoUGHIN
EST. COST
~S
~
SERVICE
PERMIT FEE
TEMP .
AMPs
CIRe's
FINAL
DATE PD.
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