HomeMy WebLinkAbout0010278-Electric (service change)_CITY OF OSHKOSH No 10278
PERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ~PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS __ G ~ r ~ C 1 ~ ~"I W cSC11-- PLAN NO.
OWNER ~~. C~C.G1 ~ v1'
DESIGN
USE/NATURE OF WORK
~.(~ ~/~G
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. 'Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR ~~~~
Electric Serv. New ^ Change ,~ Temp ^ Type ~ Volts Z 20 Amps ~d
Fixtures Switches Receptacles Circuits ~ ~
PLUMBING CONTRACTOR
BT
Lav
- WC
-Sink
Other
- WH
Sh
- FDr
LTub
Disp
- DW
SP
Eject
WSoft
DF
Ur
CBasin
-San. Sewer_
-Storm Sewer
SS -Water
FEES: Valuatio $ /~o~ ~ Permit Fee Paid $ ~ ~ Park Dedication $
ISSUED BY Date `~ Final/O.P. ~ / 0 r
In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
~'-' L G~
AGENT/OWNER
~~~
DATE
ADDRESS
TELEPHONE #