HomeMy WebLinkAbout0042363-Electrico. (~~i
n CITY OF OSHKOSH N" 42363
~' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC~PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS .~~~_~•~ d~ ~~~ PLAN NO.
OWNER
DESIGN
USE/NATURE OF WORK
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
7
ELECTRIC CONTRACTOR
Electric Serv. New~Change Temp ^ Type ~ VoIt~W
Fixtures Switches Receptacles Circuits
Amps
PLUMBING CONTRACTOR
_BT _ WH
- Lav - Sh
- WC - FDr
-Sink - LTub
Other
.oa
- Disp - WSoft _ CBasin
- DW - DF -San. Sewer
- SP - Ur -Storm Sewer
-Eject - SS -Water
FEES: Valuation $/ ~ >1~' Permit Fee Paid $ S~~' ~ ~ ' Park Dedication $
ISSUED BY ~~"`"'" /-• Date ~~~~ ~ Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER
DATE
ADDRESS
TELEPHONE ~
lj
PERMIT NO . ~Z ~ (0 3 APPL . DATE ~'/~1 5p
iy <
OWNER y
,,, ~..