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HomeMy WebLinkAbout0043620-Electric (repairs) i'l ~ CITY OF OSHKOSH PERMIT - APPLICATION A:ND RECORD to / f-/ N! ,- 43620 ~P_E~ _ _ ~L~~ _~ _ ~T~ _ C? _ ~~E?' ~~B~ _ E? _ ~I~~ _~ _ ~O_N~N~ _ _ __ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ ADDRESS ~. 2--- 9 J~ PLAN NO. OWNER DESIGNER USE/NATURE OF WORK " ~ ~-~~ kj~ < . . BUILDING CONTRACTOR Size Foundation Sq. Ft. # Rooms # Stories Height Occupancy Permit Class of Const HEATING CONTRACTOR Heat 0 AlC 0 Vent 0 Fuel/System 'j. Heat Loss BTU'S I'ELECTRIC CONTRACTOR .t3~ ~ I~~ Electric Servo New 0 Change 0 Temp 0 Type _ Volts Fixtures Switches ---- Receptacles .".--- Amps_ Circuits .----. PLUMBING CONTRACTOR _Sink Other __SS _ CBasin _ San. Sewer _ Storm Sewer _ Water _Lav _WH _Sh ~FDr _ L Tub _DiSp _OW _SP _ Eject _ WSoft _OF _BT _WC _Ur / 3. i. .. . . / FEES: Valuation $ 0 ,- .() 0 Permit Fee Paid $ ;;0, <O<J . . ISSUED BY ~ ~.t-<.IA"~ Date '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 DATE AGENT/OWNER ADDRESS TELEPHONE # PERMIT NO. t.f 3 ~ "1A7 ELEC. CO~TR. R3 t?--P iJ L OWNER ADDRESS '''2..''"L q :>LPt~ N'ATURE OF WORK & k ~ ELEC. SERVo NEW CHANGE' VESCo TYPE VOLTS FIX'S SWIS RECEPT'S' APPLIANCES . APPL. DAT~?I ~/; Y l.- 3 I ' &~ .s ~....- TEMP. AMPS CIRC'S SIGNS INSP. ROUGH N EST. COST REMARKS SERVICE PERMIT FEE FINAL 0, Ie DATE PD. ,/