HomeMy WebLinkAbout0007637-Electric (3 receptacles)_CITY OF OSHKOSH N° 07637
PERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ~LBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ' ~ ' .moo S S I ~/ Y! S T PLAN NO.
OWNERL1l ~ V ~ ~V~-e R. l vr~J ~=1 ~ C -Pv1 /~ -~'
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,/ " 1 ~ ~~->°G /r i'~ COV'
Electric Serv. New ^ Change ^ Temp ^ Type
Fixtures L~"~ Switches Receptacles
Volts Amps
~- Circuits
f
PLUMBING CONTRACTOR
-BT _WH
Lav Sh
WC FDr
Sink _ LTub
Other
WSoft
DF
Ur
SS
CBasin
-San. Sewer_
-Storm Sewer
Water
pG
FEES: Valuation $
ISSUED BY
- Disp
DW
- SP
-Eject
Permit Fee Paid $ 1 ~ ~ ~ D Park Dedication $
Date ~ ~~- - O ~ _ Final/O.P. ~ - ~ Z " ~L~
In the pertormance of this work I agree to pertorm all work pursuant to rules governing the described construction.
SIGNATURE ~ ~~ / $
AGENT/OWNER DATE
ADDRESS ~ ~ ~- u ~ ~ I - 2 3 ~ -~0 7 0 "~
TELEPHONE #
PERMIT NO ~ ` ~° 3 ~ -
-s ~- g ~
`"
~ ~~e~
NATUR OF~WORK `~
C. SERV. NEW CHANGE TE~-
e~~r n+c AMPS
IANC S
REMARKS