HomeMy WebLinkAbout0039403-Electric (service change) No 394
CITY OF OSHKOSH 3
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECPLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 4 PLAN NO.
OWNER //
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 al/f�,/e
Electric Serv. New ❑ Change y� Temp ❑ Type Volts3 �tJ Amps /0 a
Fixtures Switches T 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 ii!it--P%--/ $-0 ` C90 Permit Fee Paid $ ` v ✓ Park Dedication $
ISSUED BY ( � �r Date V / Se Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #