HomeMy WebLinkAbout0042355-Electric(~ l /
~ CITY OF OSHKOSH N°- 42355
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC~ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS ~4 `/
PLAN NO.
r
OWNER ~ .~l.L~~ ~~~
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft.
Foundation
# Rooms # Stories
Class of Const.
Height
Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR /
Electric Serv. New Change ^ emp ^ Type Volt~~ Amps/ ~ ~
Fixtures Switches Receptacles 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
FEES: Valuation $ ~®00 . O c'.~ Permit Fee Paid $ ~~®~ ®v
_ Park Dedication $
ISSUED BY Date ~ ~~ S Final/O.P. ~; ~?_ Z/~/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER SATE
ADDRESS
TELEPHONE ~