HomeMy WebLinkAbout0026625-Electric (misc.)/`'~ _ CITY OF OSHKOSH N° 26625
PERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ~LEC~ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ~ ~ ~ ~ r ~l/' K b /t PLAN NO.
OWNER_
DESIGNE
USE/NATI
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR / _ `
Electric Serv. New ^ Change ^ Temp ^ Type Volts Amps
Fixtures ~~ Switches ~~ Receptacles Circuits
PLUMBING CONTRACTOR
- BT - WH - Disp _ WSoft - CBasin
Lav - Sh - DW - DF -San. Sewer
- WC - FDr - SP Ur Storm Sewer
-Sink - LTub Eject _ SS -Water
Other
FEES: Valuation '~ Permit Fee Paid $ ! ~G_ Park Dedication $
ISSUED BY Date~~ ~~~""-` ~ Final/O.P. / ~ ~ ~(' ~~
In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE `
l ~-/o- j~
ENT/OWNER DATE
ADDRESS
TELEPHONE #
PERMI NO ~ r ~ ~i ~ APPL . _ DATE l ~ -~
- ~
ADDRESS ~~~ ~ ~ `.~~ ~ ` -
NATURE F WORK
Y
/
R S
~... ~..... AMPS
E VOL
FIX'S SW'S RECEPT'S CIRC'S
S