HomeMy WebLinkAbout0021400-Electric (service change) CITY OF OSHKOSH No 1
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC •LBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS �jY 771e,c
PLAN NO.
OWNER
DESIGNER
USE /NATURE OF WORK
5 043 3-/oo
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 G!�
Electric Serv. New Change Temp Type3' Volts :`1-vAmps i
Fixtures Switches Receptacles Circuits
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 Fee Paid Park Dedication
ISSUED BY 3/r42 f�C -//j Date O 7 L Final /O.P. ^77
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
4011
SIGNATURE .4�� s z- e d-
T /OWNER DATE
ADDRESS
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