HomeMy WebLinkAbout0039162-Electric0
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/~ CITY OF OSHKOSH N~ 39162
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ~ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS U
~/ (~ PLAN NO.
OWNER ~~° ,l/ (f ~/
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
Height .
Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR --~.~~3.fe2
Electric Serv. New Change ^
Fixtures Switches
PLUMBING CONTRACTOR
-BT -WH
- Lav - Sh
- WC - FDr
- Sink - LTub
Other
# Rooms # Stories
Class of Const.
^ Type
Receptacles
- Disp
- DW
- SP
-Eject
Volts ~ ~ Amps ~ ~
- Circuits
- WSoft
- DF
- Ur
- SS
- CBasin
-San. Sewer_
-Storm Sewer
-Water
FEES: Valuation $ ~"~~ ~ • ~ ~ Permit Fee Paid $
Park Dedication $
ISSUED BY Date ~ Z 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
DATE
ADDRESS
TELEPHONE #