HomeMy WebLinkAbout0043716-Electric (receptacles) N2 43716
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 3 YCa ti • PLAN NO.
OWNER
DESIGNER
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
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles f 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 $ /de 0 o Permit Fee Paid $ /®• Park Dedication $
ISSUED BY / 9 4.41.10.4 Date V7/9
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 #