HomeMy WebLinkAbout0010862-Electric (service change)
~
TYPE:
BLDG D
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
HTG D ELEC ~ D SIGN D ZONING
N2 1 0862
FLOOD PLAIN
HEIGHT
ADDRESS /1 ~ 3 d~
OWNER ~ 'J~ ':"'.\.a,,, "-'
DESIGNER
PLAN NO.
USE/NATURE OF WORK
. _ /7
41,J2....~ ~tr?-I
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.,
HEATING CONTRACTOR
f'
Heat D NC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
e
VOlts~~Amps !;;o/;)..<!-eJ //l.n .
~ Circuits ~ ~
Electric Servo
New D Change ~p D
Fixtures
Switches
Receptacles
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
Permit Fee Paid $
Date
J /
3:iP--v'
/CJ -IC;-Z ~
Park Dedication $
Final/O.P. 9..... _2-/ - -g-R-
ISSUED BY
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR ~ / ~_ /(j//~2P--
~ AGENT/OWNER DATE
ADDRESS
TELEPHONE #
ELEC. SERVo
DESC. TYPE
FIX~S
APPLIANCES
PERMIT NO. I t?~k APPL. DATE 7',z/-??
ELEC. CONTR.' ~
~~
~~~
17:2-3- ~ ,
c:~~~r~)
CHANGE t><:::
.3 - "-- VOLTS /;,a. .:;z. -rCJ
RECEPT'
'OWNER
; ADDRESS
NATURE OF WORK
SIGNS
INSP. ROUGHIN ~
EST. COST 525
REMARKS
SERVIC
PERMIT FEE yf'
TEMP.
AMPS CJ ()
CIRC'S