HomeMy WebLinkAbout0015819-Electric (service change)/~ CITY OF OSHKOSH N° .15819
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ~LBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS ~~ 1C.~ Y ~ ~~~~ PLAN NO.
OWNER~V~ ~CDS Imr/ r
DESIGNER
USE/NATURE OF WORK ~YV ~ ~ ~ Ana n
~ -~Q 4 ~ ~ -~a~
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 C r. 1 '
Electric Serv. New ^ Change ~emp ^ Type ~ W Volts` ~ Amps
Fixtures Switches ~ Receptacles ~ Circuits ~
PLUMBING CONTRACTOR
BT WH Disp WSoft
Lav _ Sh DW DF
WC FDr SP Ur
-Sink LTub Eject SS
Other
~~
CBasin
-San. Sewer_
-Storm Sewer
Water
FEES: Valuation $ Permit Fee Paid $ °`L/ Park Dedicatior~$ -
ISSUE~ f3Y Date ~ ~~~ i~~ Final/0.~. "'"~ .5 ~l
In the performance of this work I agree to perform atl work pursuant to rules governing the described construction.
. n
SIGNATURE
AGENT/OWNER
la/~o/~9
DATE
ADDRESS
TELEPHONE #