HomeMy WebLinkAbout0042085-Electric (receptacles)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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N!! - 42085
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ADDRESS ~3o (l) ~ r ~ t:?L/P/ ~
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PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Class of Const.
E
HEATING CONTRACTOR
Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Fixtures
New D Change D Temp D Type _ Volts _ Amps_
Switches Receptacles ~. Circuits
Electric Servo
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
/
3:.r./
!~ '~9 Y
Park Dedication $
Final/O.P.
ISSUED BY
Date
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 #
~ufY
PERMIT NO.
ELEC. CONTR. ./uI~
OWNER ~~ .
~~:::SOF ~~. ~f):;~~~
ELEC. SERV. NEW CH GE
DESC. TYPE VOLTS
FIX'S SW'S RECEPT'S.
APPLIANCES
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,APPL. DATE ~~.y:
TEMP .
AMPS
CIRC'S
SERVICE
PERMIT FEE
FINAL d.
DATE PD ~