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HomeMy WebLinkAbout0035949-Electric (move service) ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD N2 03/ 35949 ~P_E~ _ _ ~L~~ _~ _ ~T~ _ ~ _ ~~E~ )(, ~~B~ _ C? _ ~I~~ _~ _ ~O_N~N_G _ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ ADDRESS / Z-"L cl .d5 ~ aA L . PLAN NO. OWNER ~ /. J:1d/i 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 ~~ Elect';c Se",_ New 0 Change)<rTemp 0 Type~ Volts ;,W Am".lo-iJ Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR I _BT _WH _Disp _ WSoft _ CBasin _Lav _Sh _DW _DF _ San. Sewer _WC _FDr _SP ~Ur _ Storm Sewer _Sink _ LTub _ Eject _SS _ Water Other FEES: Valuation 1 (...- ", , 0 D Pe'!'" Fee Pa;d $::z;, ~ B ;;lo Date 7/ 'f ICJ,-J / I ISSUED BY Park Dedication $ Final/O.P. 9- 10- q ~ In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATU~~~~~ ~ ~-\L\'~ AGENT/OWNER DATE ADDRESS TELEPHONE #