HomeMy WebLinkAbout0036405-Electric (receptacles) CITY OF OSHKOSH N ° - 36405
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECJ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 2 (p7 S / 2 / PLAN NO
OWNER /4 - /'' i /
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 j e6C4 % -
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts 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 $ 7s0. d O Permit Fee Paid $ / rt f1 CO
� / Park Dedic ation $
ISSUED BY Date / 0`/ ��j9 3
Final /O. P.
In the performance s work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE MIPS i dk. /„ V - ) � 43
A TOO ER
DAT
ADDRESS
TELEPHONE #