HomeMy WebLinkAbout0011200-Electric (kitchen wiring)CITY OF OSHKOSH No 11200
PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS C.(i[O ~ /~ ~~~/ ~Yl/ PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
. ef-
BUILDING CONTRACTOR
Size
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 Temp ^ Type
Fixtures ~ Switches Ll Receptacles ~~
Volts Amps
Circuits f
PLUMBING CONTRACTOR
-BT WH
Lav Sh
WC _ FDr
-Sink LTub
Disp
DW
SP
-Eject
WSoft
DF
Ur
SS
- CBasin
-San. Sewer_
-Storm Sewer
-Water
Other
FEES: Valuation $ ~ ~~'Permit Fee Paid $ ,./ ~r/ Park Dedication $
ISSUED B Date ~l <~' ~~ Final/O.P..~~~d °'~~
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
A(9ENT/OWNER
ADDRESS
Sq. Ft
DATE
TELEPHONE #