HomeMy WebLinkAbout0016170-Electric (temporary)_CITY OF OSHKOSH N° 16170
PERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC [7~'~LBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS `~ -~~^ ~ PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK `'`'^~~'YJ
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ®~ Type
Fixtures ~ Switches ~ Receptacles
Volts Amps
'~ Circuits
PLUMBING CONTRACTOR
BT WH
Lav Sh
WC FDr
-Sink _ LTub
Other
Disp
DW
SP
-Eject
Heat Loss
BTU'S
WSoft
DF
Ur
SS
CBasin
-San. Sewer_
-Storm Sewer
Water
p p G V
FEES: Valuation $ ~ -~''J- Permit Fee Paid $ ` /~ q Park Dedicati/on/ $
ISSUED BY Date L ~~-~ ~ ~ / Final/O.P. l j - ,~ - ~~
In the performance of this work I agr to perform all work pursuant to rules governing the described construction.
SIGNATURE ~~`~ ~ L -~
A NT/OWNER DATE
ADDRESS
TELEPHONE #
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REMI~RKS