HomeMy WebLinkAbout0005873-Electric (service change) CITY OF OSHKOSH N° 05873
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECJ\PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS % sC PLAN NO.
OWNER / 3 2 •
- u/ - ‘ I i// l> \ ,---z,
DESIGNER
USE /NATURE OF WORK (-10—,2 4--&Y`' '
�G
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 1 71 6 At s' tl- h el:
/
Electric Serv. New ❑ Changejemp ❑ Type," Volts 1 lipAmps /Qd
Fixtures Switches Receptacles Circuits
it/2 t
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 $ / �` �"�I Permit Fee Paid $ 4 .3 ./ d "- - ' - ''
Park Dedication $
ISSUED BY ��/t /(p /7 -U 7 Final /O.P. 7 4 1 " 7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR /D /52
AGENT /OWNER 6
DATE
ADDRESS
TELEPHONE #