HomeMy WebLinkAbout0045706-Electric (service change)
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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Ng 45706
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ADDRESS
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PLAN NO.
OWNER
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
t
ELECTRIC CONTRACTOR
..
Electric Servo
New 0 Change Ipr~'''Temp 0 Type~ VOlt~ Amps Z---eJo
Switches Receptacles Circuits
'3 /H-e~
Fixtures
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
/
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ISSUED BY
Permit Fee Paid $ So · 0 0
.. Date b (ujg \ r
Park Dedication $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENTfOWNER
DATE
ADDRESS
TELEPHONE #
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PERMIT NO. tf<>7o f, . APPL. DATE
ELEC. CO~TR. ~/1'~r
OWNER
~DRESS ;}3V,.;.- Z "3 (p Vi ~ ? ct..
NATURE OF WORK
~C. SERVo
D C. TYPE
FIX'S
APPLIANCES
NEW
i) I It
SW'S
/'~
. VOLTS _ '>.1.1
RECEPT'S
TEMP .
AMPS€ {.,ffV
CIRC'S
SI"GNS
INSP. ROUGH N
EST. COST 1-0 <J
REMARKS
SERVICE
PERMIT FE
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FIN
DATE PD."
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