HomeMy WebLinkAbout0029079-Electric (service change)
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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
29079
TYPE:
BLDG D HTG D ELEC lZ!-aBG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
OWNER
923
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PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK
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BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const..
HEATING CONTRACTOR
Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR lu / T2./---c f/~c_ ':1:?J C_
Electric Servo New D Change r&l Temp D Type~ vOli~OAmps /Cf()
Fixtures Switches Receptacles IX, Circuits ~
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PLUMBING CONTRACTOR
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_WC
_FOr
_ LTub
_Disp
_OW
_SP
_ WSoft
_OF
_ CBasin
_BT
_WH
_Sh
_ San. Sewer
_Lav
_Ur
_ Storm Sewer
_Sink
Other
_ Eject
_SS
_ Water
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FEES: Valuation $ . . t>-
ISSUED BY ~ ~
Permit Fee Paid $
Date
35~
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Park Dedication $
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In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
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DATE
ADDRESS
TELEPHONE #
PERMIT' No.;l 9 (/ 7 . APPL. DATE
ELEC. CONTR. LJ ~ ~ '
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NATURE OF WORK
~~C. SERVe
m; C. TYPE
FI 'S
AP'PLIANC!:S
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TEMP.
AMPS t:J 0
CIRC'S
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SI"GN
INSP. ROUGH...N
EST. COST ')" tJ ::.;;-
REMARKS
SERVICEt'i:( - '" J; , vFINAL5- 11 -u..
PERMIT FEE J;) ~OATE PO.t - Y-J'2-