HomeMy WebLinkAbout0046453-Electric (new pole service) No �O
CITY OF OSHKOSH 46453
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC,PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS SZ r rd-6 f[6 71.11 PLAN NO.
OWNER aAt-6 J/K.¢•ld�.
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 Change Temp Type D//e-- Volts `W Amps 3
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
FEES: Valuation 9 o O Permit O
O emit Fee Paid Park Dedication
ISSUED BY Date 7 Final/O.P.
In the performance of this work 1 agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE N