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HomeMy WebLinkAbout0042085-Electric (receptacles) ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD ~tp N!! - 42085 ~P_E~ _ _ ~L~~ _~ _ ~T~ _ C? _ ~~E~;( ~~B~ _ C? _ ~I~~ _~ _ ~O_N~N~ _ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ ADDRESS ~3o (l) ~ r ~ t:?L/P/ ~ t#d-t~ ~- 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 '.(3 ,APPL. DATE ~~.y: TEMP . AMPS CIRC'S SERVICE PERMIT FEE FINAL d. DATE PD ~