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HomeMy WebLinkAbout0044565-Electric (service change) �p� � C�TY F SHKOSH N° 44565 � O O PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS ��Z� �� � � �'� PLAN NO. OWNER C�o(.(�0����L�`�L— 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 � FI FCTRIC CnNTRACT(�R_��J Electric Serv. New ❑ Change� Temp ❑ Type����v VoltsJ�l Amps��. • 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 q 0 FEES: Valuation $ jO0 Permit Fee Paid $ � Park Dedication $ ISSUED BY �'"' �^— DatP �� s � FinaVO.P. In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE . AGENT/OWNER DATE ADDRESS TELEPHONE/ � //: jv :7,`c,�w� (�3 � � PERMIT NO. (p � , P,PPL. DATE � �7�f` � ELEC. CONTR. � � OWNER /�-� � ���ESS / �Q 7 ,• � 'WATURE OF WORK � EL�C. SERV. NEW rCHP.NGFJ TEMp. � `DESC. TYPE S AMPS /��7 - � FIX' S SW'S RECEPT' S CIRC'S APPLIANCES � � � � I�GN � NSP. ROU H N SERVICE Z� FINAL �r(J ° EST. COST D � P RMIT FEE � � DATE PD. � REMARKS � � � �