HomeMy WebLinkAbout0004465-Electric (service change)_CITY OF OSHKOSH N° 04465
PERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ~PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS ~~~ ~ PLAN NO.
OWNER
DES
USE/NATURE OF WORK
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 ~ ~ ~~ / sue-' i/~lL
Electric Serv. New ^ Change ~ Temp ^ Type.~l..c> Volts ~~ ~ ~ Amps ~ o-n
Fixtures Switches Receptacles Circuits
9n4,
PLUMBING CONTRACTOR
BT WH
Lav Sh
WC FDr
-Sink LTub
Other
Disp WSoft CBasin
DW DF -San. Sewer
SP Ur -Storm Sewer
-Eject SS -Water
FEES: Valuation $ ~ ~a ~ it Fee Paid $ n~~ tl-~"~~~~j~ Park Dedication $ p
ISSUED BY Date / ^ ~ ^ ~ / Final/O. P. ~- a 8
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
~ ~ ~'
ADDRESS
TELEPHONE #