HomeMy WebLinkAbout0046082-Electric (service change)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
0<11
Ng 46082
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ADDRESS '171;; ~v/t, a~ PLAN NO.
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OWNER.?~~ ~
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Class of Con~t,
HEATING CONTRACTOR
Heat 0 AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR II~..J~ z:. ~ ~ 4~'o-~.A! ~
I 1Z (
Electric Servo New D Change 'Temp D Type Volts_
Fixtures Switches Receptacles Circuits
Amps ~"D
PLUMBING CONTRACTOR
_BT _WH
_WC
_Sh
_FOr
_ L Tub
_Disp
_OW
_SP
_ WSoft
_OF
_ CBasin
_Lav
_ San. Sewer
_Ur
_ Storm Sewer
_Sink
Other
_ Eject
_SS
_ Water
ISSUED BY
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 #