HomeMy WebLinkAbout0012328-Electric (receptacle)_CITY OF OSHKOSH RD Na 12328
PERMIT APPLICATION AND RECD
TYPE: BLDG ^ HTG ^ ELEC ~LBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ~ ~ ~ ~ /~ ~~ r1..S /// ~ ~ l' PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK '~ /'e ~ / ~ ~` ~/ -~'- ~ ~ ~ / '
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 / ~ / / ~ ~`-~C ~~'' c C Leo v
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
WSoft
DF
Ur
SS
CBasin
-San. Sewer_
-Storm Sewer
-Water
G~'V ~- < ~ v Park Dedication $
FEES: Valuation $ Permit Fee Paid $ ~ / --7 Q'
ISSUED BY Date ~ ` ! ~ ~ ~~ Final/O.P. 2 ` ~~ ~[~
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER
ADDRESS
2-/o~g9
DATE
~3i-o7o~
TELEPHONE #E