HomeMy WebLinkAbout0010946-Electric (service change)
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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
10946
TYPE: BLDG 0 HTG 0 ELEC ~ 0 SIGN 0 ZONING
FLOOD PLAIN
HEIGHT
OWNER
3(~
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I!t.-(d~o 0-
/..p II h1"ev-.
PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK
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Sep"t LlI'C'P
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BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat 0 NC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
,0
ELECTRIC CONTRACTOR &ia -- J(7ec-T
" Electric Servo New 0 Change ~mp 0 Type # Volts J) q 0 Amps I f-Q
Fixtures Switches Receptacles K Circuits I><.
0J;jJ t.
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
ISSUED BY
~/5 ~-
L/ ~G
Permit Fee Paid $ rr tJ ------ Park Dedication $
Date / LJ .-/ ij- ~Y Final/O.P. '1"~5.-;r~
- -
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER
/ cJ//q /~R-'
, DAtE .
ADDRESS
TELEPHONE #
ELEC. CONTR.
DATE Z ~ >-5-?V
PERMIT NO~
~ OWNER
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. ADDRESS
,,'
NATURE OF WORK
ELEC. SERVo
DESC. TYPE
FIX'S
APPLIANCES
CHANGE'
-f c> c:> VOLTS' ( ;J-c.J
RECEPT'S
TEMP .
cJ AMPS 0
/ CIRC' S x..
SIGNS
INSP. ROUGHIN
EST. COST r "'&1 Q ~
REMARKS
SERVI - -,2 -g FINAL7 - 21- at
P!RMIT FEE .~~ DATE PD/i-'/f-