HomeMy WebLinkAbout0017309-Electric (bath remodel)~ CITY OF OSHKOSH N°_ 17309
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS tU / 1
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft.
Foundation
# Rooms # Stories
Class of Const.
Height .
Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR y~r ~/ ~ ~ / (r .
Electric Serv. New ^ Change ^ Temp ^ Type Volts Amps
Fixtures -Switches -~~~ Receptacles) Circuits -
PLUMBING CONTRACTOR
BT WH
Lav Sh
WC FDr
-Sink LTub
Other
FEES: Valuation $ ~~• ~ ~ Permit Fee Paid $ ~~ ~ ~ Park Dedication $
ISSUED BY `~ 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
ADDRESS
Disp
DW
SP
Eject
WSoft
DF
Ur
SS
CBasin
-San. Sewer_
-Storm Sewer
PLAN NO
oC~~l~~lV
DATE
TELEPHONE #
ELEC. SERV NEW ~~~ TEr~ •-
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C TYT7S
s'~DRESS ~ ~ / - ~ ~ ~ /% i