HomeMy WebLinkAbout0033747-Electric (receptacles) l�%�-
/� CITY OF OSHKOSH N°_ 33747
�' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC�PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS �' —� A 54YL o'� . PLAN NO.
OWNER �/� �U �-
DESIGNER
USE/NATURE OF WORK /+'� r� �
BUILDING CONI�RACTOR
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 CONTRACT�R �°(► t G--
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
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FEES: Valuation $ � ��— Permit Fee Paid $ ` ✓ J Park Dedication $
ISSUED BY Date :�"LU '�� Final/O.P. ��-.25-9�i
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE /G�� �' ��
AGENTiOWNER DATE
ADDRESS �
TELEPHONE#
. 7 - �
PERMIT NO. -/ � . APPL. DATE y Z� 'y
ELEC. CONTR. ( �
OWNER
ADDRESS
NATURE OF WORK -
�.FC. SERV. NEW CHANGE TEMP.
D rC. TYPE VOLTS AMPS
FIX' S SW'S ,� RECEPT' S CIRC'S �
APPLIANCES
I�GN
INSP. ROUGH N SERVICE FINAL -��� ,�
E T. COST � °� PERMIT FEE r DATE PD. '-
REMARKS