HomeMy WebLinkAbout0023761-Electric (service change)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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23761
TYPE: BLDG D HTG D ELEC ~PLBG D SIGN D ZONING - FLOOD PLAIN- HEIGHT-
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DESIGNER
USE/NATURE OF WORK ~
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(~OAMP
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BUILDING CONTRACTOR
Size
Foundation
Sq. F!.
# Rooms
# Stories
Height
Occupancy Permit
Class of Cons!.
HEATING CONTRACTOR
Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR S"ic-fq/ý
Electric Serv. New D Change .Q;¡/Temp D TypeÆ Volt;;J......:JJ2 Amps~
Fixtures Switches Receptacles Circuits
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PLUMBING CONTRACTOR
_BT
_WH
-Sh
_Disp
_OW
_WSoft
_OF
- CBasin
- San. Sewer
_Lav
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_WC
_FOr
_LTub
_SP
_Ur
- Storm Sewer
"- Sink
Other
_Eject
-SS
_Water
Permit Fee Paid $
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Date t -I ¡J - '1/
Park Dedication $
Final/O.P. S" ~.l t7 ~ '9/
ISSUED BY
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUREJf2-yf~~:WNER t -(~T:I f
ADDRESS
TELEPHONE #
PERMIT NO. .J-.
ELEC. CONTR.
OWNER
ADDRESS
NATURE OF WORK
ELEC. SERVo
DESC. TYPE
FIX'S
APPLIANCES
SIGNS
INSP. ROUGHIN
EST. COST
REMARKS
,APPL. DATE S- - .lCJ-ff
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NEW
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TEMP.
AMPS OD
CIRC' S JC'
SW'S