HomeMy WebLinkAbout0003886-Electric~ CITY OF OSHKOSH No _03886
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC PLBG ^ SIGN ^ ZONING FLOOD_ PLAIN _ _ HEIGHT
ADDRESS ~~~ ~ ~ '~ ~~~ ~~ PLAN NO.
OWNER ~°~ "~ ~ ?~~ ~^-~~ U
DESIGNER
USE/NATURE OF WORK Lf.~ (~^ ~'' C~ ~ ~ ~ ~' - '''~ l~"G~ ~`~
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const., Occupancy Permit
HEATING CONTRACTOR
r
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S_ _
ELECTRIC CONTRACTOR ~~ (~~" ~ ~ ~~~
Electric Serv. New ^ Change ~mp ^ Type ~~ Volts ~~~ Amps ~' ~ G
Fixtures ~ Switches ~ Receptacles ~! .Circuits ~/
PLUMBING CONTRACTOR
BT WH Disp WSoft
Lav - Sh DW DF
WC FDr SP Ur
-Sink LTub -Eject SS
Other
CBasin
-San. Sewer_
-Storm Sewer
-Water
•~"-~
/ ~~G
FEES: Valuation $ ~~ ~ d4 .Permit Fee Paid $ 3(~.~ -"''~ Park Dedication $
ISSUED B Date .~~ ~,~ ~~ 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 D TE
ADDRESS
TELEPHONE #
APPL DATE
~' ~, ,,2 '-~ ~ --
PERMIT NO. _
ELEC. CONTR, ~~`'~"
t
:~
OWNER
«'
ADDRE~'~ .
NATURE fJF WORK i - - ..
600
CHANGE E
ELEC. SEI~V, N
EW~ „ p VOLTS a- ~ AMPS ~~~
'
DESC. TYPE I
RECEPT'S
_ S
~- CIRC
FIX'S ~- . I t
APPLIANCES
SIGNS SERVICE ~ - -8 FINAL « -~'~'
INSP . ROUGHIN -
PERMIT FEE
/ =~$"g
.,,/'DATE PD• 7
EXT. COST
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3 ~ u
REMARKS.