HomeMy WebLinkAbout0042209-Electric
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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N2 42209
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PLAN NO.
ADDRESS
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
f<c. Heat 0 AlC D Vent D Fuel/System
Heat Loss
BTU'S
Electric Serv.
Volts _ Amps_
--- Circuits .----
;'ELECTRIC CONTRACTOR
Fixtures
New Change D Temp D Type
~hes ------Receptacles
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _OW _OF _ San. Sewer
_WC _FOr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
FEES: Valuation $ ; () 0 O. 0 0
ISSUED BY ~
Permit Fee Paid $
Date
I~O. o~ ./
lof0 y
Park Dedication $
Final/O.P. q .~tJ.1 'i
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE ~ ~
AGENT/OWNER
/0//8/9y'
, DAfE
ADDRESS
TELEPHONE #
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PERMIT NO. tf2 ?4 7 '. APPL. DATE fl/U, /7 v
ELEC. CONTR. .~ .. ,.
OWNER I!~ K~a/.--I
N)DRES~ .3 . A. ~
NATURE OF WORK 1)1;' , -
,~
~EC. SERVo
D SC. TYPE
FIX'S
APPLIANCES
NEW
SW'S
CHANGE. TEMP .
VOLTS f~/-uJr ".3~'fW AMPS ~
RECEPT'S CIRe's
FINAL
DATE PD.