HomeMy WebLinkAbout0033798-Electric (service change) Z 3�- �
/� CITY OF OSHKOSH N° 33798
`' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC �LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / � L�,��/�,,�I(f� � PLAN NO. :
OWNER !�� �'/ C� v��r/I (�-� �'` G`
DESIGNER
USE/NATURE OF WORK -S `���'' V l C-e C � � '— f GC�
BUILDING CONT'RACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S
i ,
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change D�femp ❑ Type� Voltsl � Amps lUd
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
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FEES: Valuatio Q"� Permit Fee Paid $ ���� Park Dedication $
ISSUED BY Date -� '���-�v Final/O.P. , ` � -" � �
In the performance of this work I agree to perform alt work pursuant to rules goveming the described construction.
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SIGNATURE ^ / S //
'' AGENT/OWNER DATE �
ADDRESS
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