HomeMy WebLinkAbout0022802-Electric
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CITY OF OSHKOSH N~
PERMIT - APPLICATION AND RECORD
22802
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~./} y-?;7~LL N~
ADDRESS
PLAN NO.
OWNER
DESIGNER
w~~./~
I
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
I
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTqR
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2----G
I
Electric Servo . New 0 Change 0 Temp 0 Type _ Volts _ Amps_
Fixtures K Switches C?'----... Receptacles t~- Circuits t::><-
~/
PLUMBING CONTRACTOR
_FOr
_LTub
_Disp
_OW
_SP
_ WSoft
_OF
_ CBasin
_Lav
_WH
_Sh
_ San. Sewer
_BT
_WC
_Sink
Other
_Ur
_ Storm Sewer
_ Eject
_SS
_ Water
Permit Fee Paid $
Date
;? CJ C~
1--,;z-~/
Park Dedication $
Final/O.P. q; ~:). 1- q I
ISSUED BY
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
~~J/ A /
C /~-
i~ 1'1- -9 /
DATE '
ADDRESS
TELEPHONE #
52-~r-o ;J--
PERMIT NO.
ELEC. CONTR.
ADDRESS
NATURE OF WORK
1r; "1, /I-~
/ ~if~:c;?
VOLTS
{~__ RECEPT' S t/'-.
e-></
OWNER
ELEC. SERVo NEW
DESC. TYPE S
FIX'S ~ W'S
APPLIANC S
TEMP.
AMPS
CIRC'S ~
SIGNS
INSP. ROUGHIN ~
EST. COST
REMARKS
SERVICE FINAL
PERMIT FEE t?~ATE PD.