HomeMy WebLinkAbout0040496-Electric (receptacles) CITY OF OSHKOSH N ° - 40496
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC j PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /3 PLAN NO.
OWNER �r.r�
DESIGNER O
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 174-7c.,•,d/
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles ircuits
R Lo U)
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: Valuatio $ Permit Fee Paid $ to • ° Park Dedication d cation $
ISSUED BY Date 7 //J , f 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 #
PERMIT NO. S 4 . APPL . DATE 03/03‘
ELEC. CONTR. Defli. r. /
^OWNER c71-41.1--: ADDRESS 44g./14--
'NATURE OF WORK
F,LEC. SERV. NEW CHANGE TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'SA, CIRC'S
APPL y�
SIGN �/
INSP. ROUGHIN SERVICE FINA144 C
EST. COST 'D.o n PERMIT FEE /0-00 DATE PD.7 0>ifiy
REMARKS
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