HomeMy WebLinkAbout0017288-Service Change
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CITY OF OSHKOSH N2
PERMIT - A-PPLICATION AND RECORD
17288
TYPE:
BLDG 0 HTG 0 ELEC ~LBG 0 SIGN 0 ZONING
FLOOD PLAIN
HEIGHT
OWNER
/ 3;-/'11 I~ ~.
k'- I?t? ~A..7~
PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK
PtA~ - yt~ ~
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 SeN. New ~h""ge 0 Temp 0 Type~ ~ Volts '%^ ~.
Fixtures L/ 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
ISSUED BY
I
/5 -&;:1 i:? -l/
Permit Fee Paid $ .~
Date :2 ,--.;2-2.. - 9'2J
Park Dedication $
Final/O.P.
3-;).() -90
In the performance .of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
r?~ 4 +- ,"m_"
c?- -;2;;'- <1 cJ
DATE
ADDRESS
TELEPHONE #
OWNER
-/S-7'Lj
PERMIT NO.
E C. CONTR.
ADDRESS
NATURE OF WORK
SI'GNS
INSP. ROUGHI . I}o
EST. COST /:v d' 0 CJ C' :
REMARKS