HomeMy WebLinkAbout0025750-Service Change
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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
25750
TYPE: BLDG D HTG D ELEC.Ai PLBG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
ADDRESS
/~~
PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
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BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat 0 NC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
Electric Serv.
rAmps ot:J t:J
ELECTRIC CONTRACTOR
Fixtures
New 0 . Change M
SW;lch~;~
Circuits
~
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _OW _OF _San. Sewer
_WC _FOr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
ISSUED BY
J.
. Cr cC- /IY -~.;
?!?CJ CJ - Permit Fee Paid $ /';j Park Dedication $
Date /tJ ;/ If:. '--~ Final/O.P.
FEES: Valuati
In the performan e of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
tDhfJ~ 1-
ADDRESS
TELEPHONE #
PERMIT NO. ;2 S- ~ 0," APPL. DATE 7 -1..-<7'- '7/' Iv
::~ CONTR. 7~~~
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ADDRESS
NATURE.OF WORK
S?/:"GNS
INSP. ROUGHIN
EST. COST
REMARKS
SERVICE
"':;;'--- PERMIT FEE /
TEMP .
AMPS 0
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ELEC. SERVo NEW
DESC. TYPE
I~X'S SW'S
APPLIANCES
CHANGE
3-?:5-, - . ~IuVOLTS
RECEPT I
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