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HomeMy WebLinkAbout0039008-Electric (service change) ~ 1p31 N2 ~ 39008 CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD ~~P_E~ _ _ ~L~~ _~ _ ~T~ _ C? _ ~~E~ j{ ~~B~ _ C? _ ~I~~ _~ _ ~O_N~N_G _ _ _. _ _ _ _F~~~D_ ~L~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ OWNER /63'1 /~ ~A-U ~~ ('. PLAN NO. ADDRESS DESIGNER USE/NATURE OF WORK BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. ~ ~ HEATING CONTRACTOR .. Heat 0 AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR ~ / Electric Servo New 0 Change ~ Fixtures Switches Temp 0 Type CJ / #- Volts:f cd Amps I~ f) Receptacles Circuits PLUMBING CONTRACTOR _BT _WH _Disp _ WSoft _ CBasin _Lav _Sh _OW _OF _ San. Sewer _WC _FOr _SP _Ur _ Storm Sewer _Sink _LTub _ Eject _SS _ Water Other FEES: Valuation $ ISSUED BY Permit Fee Paid $ Date 3s-. c 0 ~u/c;y Park Dedication $ Final/O.P. 1.2.J~ .tlf In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE~ ~ ~ct:/Y'</ AGENT/OWNER DAT ADDRESS TELEPHONE # PERMIT NO. ?90()(' ELEC. CONTR. ~ (~PWNER L {/d-~ . ( .. ADDRESS / b '3 'f- Af~./ . -NATURE OF WORK . . APPL. DATE I <'ef""L- #;?_;Ir ~ /f:? SW'S ....<cHANr..v . . .. VOLTS '3 I.fJ " / #- RECEPT I S' TEMP. AMPSlfhI CIRC'S ELEC. SERVo DESC. TYPE FIX'S APPLIANCES NEW SI'GNS INSP. ROUGH EST. COST .BEMARKS ..C-f/ Sll:RVICE I. PERMIT FEE FINAL I DATE PD. .+ ,~~~~~---