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HomeMy WebLinkAbout0047519-Electric (service change) ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD h3j N!-47519 ~P_E~ _ _ ~L~~ _~ _ ~T~ _ 9 _ ~~E~ ~_ ~~B~ _ C? _ ~I~~ _~ _ ~O_N~N~_ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ ADDRESS 19 Cf2- ~~~ ~ p~{~??~ PLAN NO. OWNER DESIGNER USE/NATURE OF WORK ~.: ~ BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. HEATING CONTRACTOR Heat D AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR ~~/ Electric Servo New 0 Chang~emp 0 TYP~Volts 5 cd Amps /N Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR _BT _WH _Disp _ WSoft _ CBasin _Lav _Sh _DW _DF _San. Sewer _WC _FDr _SP _Ur _ Storm Sewer _Sink __ L Tub _ Eject _SS _ Water Other FEES: Valuation $ ~ . [) e ISSUED BY ~. Permit Fee Paid $ Date 1/ 3r-.~/' IfJ/Y: ~ ) ~ 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 #