HomeMy WebLinkAbout0033019-Electric~~~
CITY OF OSHKOSH N°_ 33019
n PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC [~~A'~G ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ~a ~/ ~~ `~~~~
~--, PLAN NO.
OWNER ®°~~' '~
DESIGNER
USE/NATURE OF WORK Ci~`""""'"""'Q'~~
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 (~ange ^ Temp ^ Type~~~~ Volts Amps ~
Fixtures witchesReceptacles y 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
m
FEES: Valuation $ ~ D Permit Fee Paid $ ~®c-`'-_ Park Dedication $
ISSUED BY Date r~ J ` ,~_
~ Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction
SIGNATURE
ADDRESS
~J ~//
ENT/OWNER DATE
TELEPHONE #
~r,rse~-rcx~