HomeMy WebLinkAbout0011450-Electric (temporary)
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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
11450
TYPE:
BLDG D HTG D ELEC ~LBG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
USE/NATURE OF WORK
/7"bJ~~~
'X'7~ ~
~.
7'
PLAN NO.
ADDRESS
OWNER
DESIGNER
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
, Occupancy Permit
Foundation
Class of Cons~.
HEATING CONTRACTOR
Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
d-. 77 ~
Electric Servo
New D ChangeD Temp ~ Type _ Volts _ Amps .G 0
Fixtures
Switches
Receptacles
Circuits
WJ
PLUMBING CONTRACTOR "-
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _OW _OF _ San. Sewer
_WC _FOr _SP _Ur _ Storm Sewer
_Sink _ LTub _ Eject _SS _ Water
Other
ISSUED BY
/
~OV ~'
Permit Fee Paid $ ~
Date //-- i'o. -g-O-
Park Dedication $
Final/O.P. .I / - / 0 -? cr-
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
/7 ho-r g-
/ DATE
ADDRESS
TELEPHONE #
ELEC. SERV.
DESC. TYPE
FIX'S
APPLIANCES
:/ -/c:7 -% r
PERMIT NO.
ELEC. CONTR.
OWNER
ADDRESS
NATURE OF WORK
CHANGE
VOLTS
RECEPT
TEMP.
AMPS
CIRC' S ~
SIGNS
INSP. ROUGHIN
EST. COST
REMARKS
'--'
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