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Home My WebLink About0007019-Electric (receptacles) � _ CITY OF OSHKOSH N°_ 07019 PERMIT APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS � � � � �_.�. �� PLAN NO. OWNER �1T'�._-� � A 1 1 � : 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 �� `�C`TT ,\ L- Electric Serv. New ❑ Change ❑ Temp ❑ Type Vol�,z Amps / Fixtures Switches Receptacles °� Circuits E 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 dr FEES: Valuation $ �`�"�� Permit Fee Paid $ ✓- Park Dedication $ ISSUED BY Date� �� D� Final/O.P. � ��—�� In the performance of this work I agree to perform all work pursuant to rules governing the described const�uction. SIGNATURE � I 2 �� AGENT/OWNER DATE � .. ADDRESS TELEPHONE# ' � t PERMIT NO�� . P . TE �//-C � ELEC. CO TR � OWNER � � / /(./ � f F ADDRESS ��/ � � NATURE OF WORK FT.EC_ SERV. NEW CHANGE TEMP. SC. T E VOLTS AMPS FIX'S RECEPT'S CIRC'S APPLIANCES � IGNS INSP. ROUGH N ERVICE FI A A/-z EST. COST 5"'0 =�� PERMIT FEE �i DATE PD.2y�`S�' � REMARKS � � � „ �