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HomeMy WebLinkAbout0039004-Electric ~ N2 &Vz-- 39004 CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD :~P_E~ _ _ ~L~~ _~ _ ~T~ _ C? _ ~~E? ~_ ~~B~ _ C? _ ~I~~ _~ _ ~O_N~N~ _ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ 3?tJ ~ r~ ~~g)~. ADDRESS PLAN NO. OWNER ,~~ DESIGNER USE/NATURE OF WORK BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. HEATING CONTRACTOR Heat D AlC D Vent D Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR L New 1- Change D Switches WtV . olts IZo/~~ Amps!-z..ou (!:" Fixtures Temp D Receptacles Circuits Electric Servo PLUMBING CONTRACTOR _BT _WH _Disp _ WSoft _ CBasin _Lav _Sh _DW _DF _ San. Sewer _WC _FDr _SP _Ur _ Storm Sewer _Sink. _LTub _ Eject _SS _ Water Other FEES:. Valuation $ ;;2. /; 0.0 (). 0 0 Permit Fee Paid $ ISSUED BY .~ d"'A~ Date I- . 177. S-o ./1 V/u/4 'f , I Park Dedication $ Final/O.P. 4-.:Jt ljtl I In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE a:;Z ~~&'. 7;/ e9 'T /'74" . DA-rE ADDRESS TELEPHONE # \ PERMIT NO. 3CJ()(J'f ,APPL. DATE ELEC. CONTR. ~ OWNER ~. ~Mr, ~ ~DRESS 37tJ 4{~ ~ }lATURE OF WORK '';..d ~..Aj' E EC. SERV. CHANGE D SC. TYPE VOLTS I~ FIX'S SW'S RECEPT' APPLIANCES 3/14 ~. I (p~. TEMP . AMPS l..-d () CIRC'S ?L4k ~ c../ SERVICE 3 II t; ~ PERMIT FEE . ZJ 3 ~ c./W (i) FINAL DATE PD. SIGNS INSP. ROUGHIN EST. COST REMARKS r//7/4' ~ ~A-"-L___ (J()t). 0 p