HomeMy WebLinkAbout0038499-Electric (service change)l~3 f~
N°_ 38499
CITY OF OSHKOSH
n PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC [~ PLBG ^ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS ~ C~ ~ 7 C~.t.~.'~l(,/.C/L f~UiUr'C PLAN NO.
OWNER
DESIGNER
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
Electric Serv. New ^ ChangeTemp ^ Type ~ Volts Amps
Fixtures Switches ~ ~' Receptacles -~,~2~- Circuits
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 $ ~0 ~ ` ~ ~ Permit Fee Paid $ ~ S~ o
)~ ~ Park Dedication $
ISSUED BY___7,~~"" r/~--~' Date Final/O.P. ~~~~
r
In the pertormance of this work I agree to perform I work pursuant to rules governing the described construction.
SIGNATURE ~ l rp
AGENT/OWNER DATE
ADDRESS
TELEPHONE ~