HomeMy WebLinkAbout0046231-Electric (service change)
~
~5Y
CITY OF OSHKOSH N~ 46231
PERMIT - APPLICATION AND RECORD
:r':P_E~ - _~L~~ -~ _~T~_~- ~~E~){ ~~B~_~- ~I~~ -~ _~O~~N~_~- _F~~~D_~~I~~- ~~I~~T~
ADDRESS & /f ~~ 4r-
, ¿
OWNER ~ ~
PLAN NO.
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR ß «
Electric Servo New D Chang~ Temp D Type ~Volts~
Fixtures Switches Receptacles Circuits
Amps Lð:i2
PLUMBING CONTRACTOR
_BT _WH
_Lav _Sh
_WC _FDr
_Sink _LTub
Other
FEES: Valuation $ '&-J ,C)O
ISSUED BY
_Disp _WSoft - CBasin
_DW _DF - San. Sewer
_SP _Ur - Storm Sewer
-Eject _SS _Water
/
-? ,/
Permit Fee Paid $ G--C), cJ <J
Date 7/Z-J~ ,>"-
Park Dedication $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
DATE
AGENT/OWNER
ADDRESS
TELEPHONE.