HomeMy WebLinkAbout0031961-Electric (service change) CITY OF OSHKOSH N° 31961
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC [ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /7r 4 A PLAN NO.
OWNER .7n—' 7Aoto .
DESIGNER
USE /NATURE OF WORK —4. --
( 3 / do 3 a 0
®g, w ,4
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
4 .____7 _ ,7 1 7,
ELECTRIC CONTRACTOR
U
Electric Serv. New ❑ Change —mp ❑ Type k"Volts iS Amps � at-t.)
Fixtures witches `...---- Receptacles ' `--
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
_ z
FEES: Valuation $ .% Perm Fee Paid $ O•/ '- Park Dedication $
ISSUED BY Date Z-- —( 77--- Final/O.P.
In the performance of this wo . I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE d _ ��9L
/ Ar NT /OWNE DATE
ADDRESS '
TELEPHONE #