HomeMy WebLinkAbout0023505-Electric (service change)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
N~
23505
TYPE:
BLDG D HTG D ELEC ~LBG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
OWNER
<;?2 3 . ~,.(.
0L-~~~ 2/ c2eJ7 ~
/
PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK
/!&J ~
;;;..--- '} tJ ~) .. /"6-0
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat D NC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
-& Amps /~
Fixtures
New D Change ~mp D
L..sv;itches ...-- Receptacles
--
~J
Electric Servo
PLUMBING CONTRACTOR
_Sink
_FOr
_LTub
_OW
_SP
_ WSoft
_OF
_ CBasin
_BT
_WH
_Sh
_Disp
_Lav
_ San. Sewer
_WC
_Ur
_ Storm Sewer
_ Water
_ Eject
_SS
i Other
"
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Permit Fee Paid $
Date
5ttf~
5 <-?-9"-7:/
,
Park Dedication $
Final/O.P. S-;2.y-V'
ISSUED BY
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
GENT/OWNER
S~?-'7/
/ DATE ./
ADDRESS
TELEPHONE #
SI'GNS
INSP. ROUGHIN
EST. COST 1 LJP~ .~
REMARKS
=
5" --/? ;.. 7/
PERMIT NO.
ELEC. CONTR.
OWNER
.~
TEMP. .~
~S~t:)
CIRC'S
ADDRESS
NATURE OF WORK
ELEC. SERVo
DESC. TYPE
FIX'S
i12PLI~CES
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