HomeMy WebLinkAbout0028627-Electric (service change) CITY OF OSHKOSH N° 28627
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC EIPLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 3 5/9/ 4+- PLAN NO.
OWNER Jet' 4
DESIGNER
USE /NATURE OF WORK ':.4 /_«i I, AO ..1
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 4 2 A l c /Cr
Electric Serv. New Change -Temp 0 Type _mow VoltsLVAL Amps)
Fixtures Switches Receptacles Circuits °G)-
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
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FEES: Valuation go Permit Fee Paid aS ellal Park Dedication
i
ISSUED BY /A_/ -.i/ Date 5 77 Final /O.P. 5 7-
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE //it L S N Iq
AGENT /OWNER DATE
ADDRESS
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