HomeMy WebLinkAbout0043629-Electric (service change)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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N! - 43629
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ADDRESS
1l/3 5~
PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft.
Foundation
# Rooms
# Stories
Height
Occupancy Permit
Class of Const.
HEATING CONTRACTOR
Heat 0 AlC D Vent D Fuel/System
Heat Loss
BTU'S
Q
,. ELECTRIC CONTRACTOR ~~r
Electric Servo New D Chang~~Temp D Type t?/ /rLvolts 3G(./ Amps ?O~
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
_WC
_Ur
_ CBasin
_ San. Sewer
_ Storm Sewer
_Lav
_DW
_SP
_ WSoft
_DF
_BT
_WH
_Sh
_FOr
_ L Tub
_Disp
_Sink
Other
_ Eject
__SS
_ Water
FEES: Valuation $ ?iO 0, .0 0 Permit Fee Paid $ '2..0 . c:>-oV
ISSUED BY S)d'-"/ /~<A/~- Date ((30/:'r-
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
AGENT/OWNER
DATE
ADDRESS
TELEPHONE #
PERMIT NO. If'3 C, 2-1
ELEC. CONTR. iluy ~
OWNER
WDRESS I}C) .:7-~
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FIX'S
APPLIANCES
'GNS
IN P. ROUGH N
EST. COST
REMARKS
NEW
FINAL
DATE PD(
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