HomeMy WebLinkAbout0046219-Electric
~
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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N!! 46219
~P.E~ _ _ ~L~~ _~ _ ~T~ _ ~ _ ~~E~ Y- ~~B~ _ C? _ ~I~~ _~ . ~O_N~N~ _ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _
ADDRESS .37 (p ~. /( ~ ~ -1 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 ~
Electric Servo New D Change D Temp D Type - Volts - ~-
Fixtures ~witches . ~ Receptacles --- Circuits
PLUMBING CONTRACTOR
_BT
_WH
_Sh
_FOr
_ L Tub
_Disp
_OW
_SP
_ WSoft
_OF
_ CBasin
_WC
_Ur
_ San. Sewer
_ Storm Sewer
_ Water
_Lav
_Sink
Other
_ Eject
_SS
FEES: Valuation $
ISSUED BY
000.0.0
~
Permit Fee Paid $
Date
~S-O. ~ 9
/l.)1<3 ~,-
Park Dedication $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER
DATE
ADDRESS
TELEPHONE #
PERMIT NO. yiP 2/) ,APPL. DATE 1~y lq ';{"
ELEC. CONTR. ~ :
OWNER'~ ~I'I.)U-
~RESS ~'11o ~. ~~
NATURE OF WORK (. "
{pI.fJ
ELEC. SERVo
o se. TYPE
FIX'S
APPLIANCES
v<h.
CHANGE
VOLTS , ~
RECEPT'S
S I'GNS
INSP. ROUG IN
EST. COST
REMARKS
FINAL
DATE PD. -
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PERMIT