HomeMy WebLinkAbout0046695-Electric (service change)63'
N_
4 6 6 A
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ! / �d �" �" ' PLAN NO.
OWNER �� o
DESIGNER
USE /NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft
# Rooms # Stories Height.
Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR --,-z-
Electric Serv. New ❑ Chan e "XTemp ❑ Type
Fixtures Switches Receptacles —
PLUMBING CONTRACTOR —
_BT —WH
Lav
_ WC
Sink
Other
Sh
FDr
— LTub
Disp
_ DW
SP
Eject
VOlts7 Amps
Circuits
WSoft
— DF
Ur
_SS
CBasin
San. Sewer_
Storm Sewer
Water.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENVOWNER
DATE
ADDRESS TELEPHONE #
FEES: Valuation $ 6� • y (y�
ISSUED BY `�
Permit Fee Paid $
Date
• " r�G
Park Dedication $
Final /O.P.
Z 7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENVOWNER
DATE
ADDRESS TELEPHONE #