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HomeMy WebLinkAbout0033901-Electric (service change) ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD ~ 31/ N2 33901 ~~P_E~ _ _ ~L~~ _~ _ ~T~ _ C? _ ~~E? _ ~ ~~B~ _ C? _ ~I~~ _~ _ ~O_N~N~ _ _ __ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ ADDRESS 177 r;;)?S~Jat( J( PLAN NO. OWNER DESIGNER S;.J<l/(c2; e~tl 0' G. 0 -fo ,7. /(llJ 0 rI USE/NATURE OF WORK BUILDING CONTRACTOR Size Sq. Ft. # Rooms . # Stories Class of Const. Height Occupancy Permit Foundation HEATING CONTRACTOR Heat D NC D Vent D Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR --r: tJ1L 'f/I;.( J.OJ t, " ~; Electric Servo New D Change ~ Temp D Typ~ VOlts~ Amps.Lt.1lL- 0'/1. rJ Fixtures Switches Receptacles f><__ Circuits ~ ~ t; Pi 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 tJI6 ":::'----Permit Fee Paid $ Date I ~tJ~ S-/?-lj Park Dedication $ Final/O.P. .5' -/ ? -? 3' FEES: Valuation ISSUED BY w rk I agree to perform all work pursuant to rules governing the described construction. SIGNATURE _. a ~ - 14 J:J , riA TE ADDRESS TELEPHONE #