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HomeMy WebLinkAbout0017939-Electric ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 17939 ~~P_E~ _ _ ~L~~ _~ _ ~T~ _ C? _ ~~E~~ ~~B~ _ C? _ ~I~~ _~ _ ~O_N~N~ _ _ _ _ _ _ _F~~~D_ ~L~~d~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ /,5"",-3> 6'-~ ,~~~ 03t?-~ ~ ADDRESS PLAN NO. OWNER DESIGNER USE/NATURE OF WORK BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. HEATH',G CONTRACTOR .-i~~ Heat 0 AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR 2 t.AJ :r E-R. S E L E C' c Electric Serv, Ne~ange 0 Temp 0 Type ~ ~olts ~o Amps_ Fixtures {>Z Switches ~'Heceptacles ~Circuits ~ ,. ~ PLUMBING CONTRACTOR _Sink Other _FDr _ L Tub _Disp _DW _SP _ WSoft _DF _ CBasin _BT _WH _Sh _ San. Sewer _Lav _WC _Ur _ Storm Sewer _ Eject _SS _ Water FEES, Valua';o" $ I~C__ ISSUED BY~ ~ Permit Fee Paid $ Date / /5'".0& 3,' ~-/~--70 Park Dedication $ Final/O.P. )!~. (p - ? 0 In the performance of this work I agree to perform all work pursuant to rules governing the described construction. , SIGNATURE ~ ~""OW,," L//IJ/9d t Ot>/:E ADDRESS TELEPHONE # EIJ;C. CONTR. "3 -;2 ~ -9Z' PERMIT NO. I 773 F . 1.7 (7'5' - ;(J/J/1~ ~ ~-=-~ NEW CHANGE TEMP . VOLTS AMPS SW'S RECEPT'S CIRC'S O~;~R . SI'GNS INSP. ROUGHI EST. COST REMARKS SERVICE PERMIT FEE