HomeMy WebLinkAbout1994-Electric (service change)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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40545
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OWNER
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PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
# Rooms
'# Stories
Height
Occupancy Permit
Class of Const.
I
HEATING CONTRACTOR
Heat 0 AlC D Vent D Fuel/System
Heat Loss.
BTU'S
~ ELECTRIC CONTRACTOR ~/ ~
, Electric Servo New D Change D Temp p(: Type ol/.../- VOlts2.1&L Amps I tJ7)
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
Park Dedication $
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 #
6'(-0
PERMIT NO.
tJJ--- Jr . APPL. DATE 7/-0 Y
ELEC. CONTR.
OWNER ~ 9~1 ~
t' (/
ADDRESS 1333 U/~~
NATURE OF WORK
"*
ELEC. SERVo NEW
DESC. TYPE
FIX'S SW'S
APPLIANCES
CHANGE
VOLTS "'3 (.
RECEPT'S
FINAL
DATE PD.
SI'GNS
INSP. ROUGHIN
EST. COST
~KS
SERVICE
PERMIT FEE