HomeMy WebLinkAbout0029857-Electric~ CITY OF OSHKOSH N°- 29857
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ~LBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ~ ~O /1 i.zK cxc 'J~ PLAN NO.
OWNER ~- ~~ ~~ t4 ~A
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
# Rooms
Class of Const
# Stories
Height .
Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR ~9~--~ ~ t, Q ~
Electric Serv. New Change ^ Temp ^ Type Volts~f2 Amps a'Be tea D,~ K ~K,ors~
Fixtures ~/ Switches ~ Receptacles ~~ Circuits •~
i
PLUMBING CONTRACTOR
BT WH
Lav _ Sh
- WC _ FDr
-Sink LTub
Disp WSoft
DW DF
SP Ur
-Eject SS
CBasin
-San. Sewer_
-Storm Sewer
-Water
Other
FEES: Valuation $ w - ~~ ~ O -~ Permit Fee Paid $ rJ .7 ~^ Park Dedication $
ISSUED BY rr/ ~-S~/~~ Date ` ~ %l ~ f f Z Final/O.P. ~~ ~S l
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE h ~ ,~~~~ ~_ ~ ~~
AGENT/OWNER A
ADDRESS_ oZo.2-- ~ '~ ..yea~ ~ t~ o~~,~"'y-~G~Z
TELEPHONE #