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HomeMy WebLinkAbout0036117-Electric (fans/fixtures) ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD t;3Y: ",'"3 N~ 36117 ~P:: . . ~L~~ .C! . ~T~. o. ~~E~.K PLSG . C? . ~'GN .0 . ZONING. . . . . . FLOOD PlJI'N. . . . . . HEI~HT . . . . ADDRESS If L ( 4~ PLAN NO. OWNER 7~ 41~o/LA DESIGNER USE/NATURE OF WORK BUILDING CONTRACTOR Size Foundation Sq. Ft. # Rooms # Stories Height Occupancy Permit Class of Const. HEATING CONTRACTOR Heat 0 AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR tt/~ Electric Servo New 0 Change 0 Temp D ;~1r~ Type _ Volts _ Amps_ ~ Fixtures Switches Receptacles Circuits " PLUMBING CONTRACTOR _FOr _Disp _OW _SP _ WSoft _OF _ CBasin _BT _WH _Sh _ San. Sewer _Lav _WC _Ur _ Storm Sewer _Sink Other _ L Tub _ Eject _SS _ Water FEES, val"atiO~O. <20 Pe"'lil Fee Paid $ ~Oqj ISSUED BY . ~U.AhA,~ Date qkd~ ~ / ,/ Park Dedication $ Final/O.P. 9 ~J.-4 ~9.3 In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE 42}u)~~ { AGENT/OWNER DATE ADDRESS TELEPHONE # PERMIT NO. '3~ Ilr , ELEC. CO~TR. I/)If~ OWNER .40 ~ ~DRESS /f?-/, ", ~ 'W-= OF WORK -,,~ -/~ -. ,- iLEC. SERV. NEW CHANGE "OESC. TYPE VOLTS EIX'S SW' S RECEPT'S APPLIANCES ,APPL. DATE lj~() 1,r3 , I TEMP. AMES CIRC'S SI'GNS INSP. ROUGHIN EST. COST 5'0 D ~ C) LJ REMARKS SERVICE PERMIT FEE (....D ,0 ~ = =