HomeMy WebLinkAbout0019923-Electric (service change)~ CITY OF OSHKOSH N°_ 19923
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC~LBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS
OWNER
'G K-
PLAN NO.
DESIGNER
USE/NATURE OF WORK i~,l~~ ~5~1~1 C~ ~'-'~~ ~ L~ ~7 ~O V
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 ~ S~G~~
Electric Serv. New ^ Change ~emp ^ Type ~_~ Volts ~Q~Amps ~ v~7
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
BT WH
Lav Sh
WC FDr
-Sink _ LTub
Other
Disp
DW
SP
-Eject
WSoft
DF
Ur
SS
- CBasin
-San. Sewer_
-Storm Sewer
-Water
FEES: Valuation $ ~' ~ ~ Permit Fee Paid $~~ Q ~~77 '/ Park Dedication $ d
ISSUED BY Date ~j _~ Final/O.P. ~_ a -~~
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~4 ~G ~~ ~ / ~-`
~~
ENT/OWNER DATE
~'
ADDRESS
TELEPHONE #