HomeMy WebLinkAbout0004250-Electric (misc.)
~
CITY OF OSHKOSH N~
PERMIT - APPLICATION AND RECORD
04250
TYPE:
BLDG 0 HTG 0 ELEC ~G 0 SIGN 0 ZONING
FLOOD PLAIN
HEIGHT
ADDRESS ~d.1
--
OWNER "1 e(-. P
!-lIrA
, ,
01/1 lQn,5
PLAN NO.
DESIGNER
USE/NATURE OF WORK
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BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
, Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
4 Heat 0 NC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
..
ELECTRIC CONTRACTOR
;-Ioe hI} '€- [2/ e c-
Electric Servo
New 0 Change 0 Temp 0 Type _ Volts_
Switches L---'" Receptacles ~ Circuits
Amps_
~~,
Fixtures
PLUMBING CONTRACTOR
l _BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
".
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
Permit Fee Paid $
Date
)
/->~V
. ..A- Park Dedication $
c: -(~- ? 7 Final/o.p.b - (2{- 2'7
ISSUED BY
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR~./ jJ~
AGENT/OWNER
~ //f"'lrf?
r DATE
ADDRESS
TELEPHONE #
PERMIT NO. (!) vi ;2.l;;e; APpL. DATE )--I"} -1f 7
ELEC. CONTR. I/~~~
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d-2 f ~ H0 '
OWNER
ADDRESS
~ATURE OF WORK
CHANGE.
VOLTS
RECEPTtS
..r=
TEMP.
AMpS
CIRC'S ~
,
ELEC. SE~V. NEW
'. DES C. TYPE
FIX'S C><.- <') ~ ~
APPLIANCES
SIGNS
INSP. ROUGHIN
EXT. COST ;2..
REMARKS
SERVICE
PERMIT FEE ~___