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HomeMy WebLinkAbout0043175-Electric D ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD (PIc- N2- - 43175 ~P_E~ _ _ ~L~~ _~ _ ~T~ _ E? _ ~:E~ _~ _ ~:B~ _ C? _ ~I~~ _~ _ ~O_N~N~_ _ _ _ _ _ _F:~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ ADDRESS J30L~~. JJ?d~ X'.~/{ PLAN NO. OWNER DESIGNER USE/NATURE OF WORK BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. HEATING CONTRACTOR Heat D AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR t3Q ~Au ,/t1.U-t.a;P /d./d.,.( ~i:l-u~ Electric Servo New 0 Change 0 Temp 0 Type_ Volts_ Amps_ F'lxt ures .---e" Switches ___- ------ CI'rcuits ---- ./ Receptacles PLUMBING CONTRACTOR _WC _WH ~Sh _FDr _ L Tub _Disp _DW _SP _ WSoft _OF _ CBasin _BT _Ur _ San. Sewer _ Storm Sewer _Lav _Sink Other _ Eject _SS _ Water FEES: Valuation $ ~O 0 0 . () 0 Permit Fee Paid $ ISSUED BY ~~~~ Date // S-O. 0 0'/ ~/~y~li~ 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 AGENT/OWNER DATE ADDRESS TELEPHONE # C, 1'- PERMIT NO. tfJ 17 -.s" . AfPL. DATE ~/lo Eu!C. CONTR. ~ Q Owt~ER M~..~lt: ADDRESS /30'z- ~~~~ NATURE OF .ltl()Rt( . t~tI ~C. S~RV. NEW CHANGE DESC. TYPE VOLTS FIX'S SW'S RECEPT'S APPLIANCES TEMP . AMPS CIRC'S ____ _.__m _______m__n_ ~._- ...-.-.--.,.----~.~- ~// y / / /