HomeMy WebLinkAbout0045867-Electric (service change)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
~3Y
Ng 45867
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ADDRESS 90S- ~~ PLAN NO
OWNER IU~ ~~ .
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Class of Canst.
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
"
,.ELECTRIC CONTRACTOR
Electric Servo New 0 Change~Temp 0
Fixtures Switches Receptacles
Circuits
PLUMBING CONTRACTOR
_BT _WH
_Lav
_Sh
_FOr
_ L Tub
_Disp
_OW
_SP
_ WSoft
_OF
_ CBasin
_ San. Sewer
_ Storm Sewer
_ Water
_WC
_Ur
_Sink
Other
_ Eject
_SS
/
I
Permit Fee Paid $ ;)0 . .Q tJ j
Date 7/'/9 jr
Park Dedication $
Final/O.P.
ISSUED BY
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 #
iL -C-I J ~~I Lor
PERMIT' NO. 7:j 0(0 I . APPL. DATE {.!. (:1\
ELEC. CONTR..IJ~~
OWNER ' tJ ,A-UA ?- /1 ~
ADDRESS 7 () ~ ;</ ~ /
NATURE OF WORK . I
l'
LEC. SERV. NEW
IlESC. TYPE U
fIX'S SW'S
APPLIANCES
b 5' .Y'
TEMP .
AMPS 2--H
CIRC'S
SIGNS
INSP. ROUGHIN
EST. COST
REMARKS
SERVICE 'i 11
PERMIT FEE
FINAL ON (::
DATE PD.
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