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HomeMy WebLinkAbout0043156-Electric (service change) ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD fp3Y N~ - 43156 ~P.E~ . _ ~L~~ .~ _ ~T~ _ ~ _ ~~E~ _ ~_ ~~B~ _ ~. ~I~~ _~ _ ~O_N~N~ _ _ _ _ _ _ _F~~~D_ ~~I~ _ _ . _ _ _ ~~I~~T_ . _ . _ ADDRESS /lfZ--7 Il~ PLAN NO. ' 11~ ~r OWNER DESIGNER USE/NATURE OF WORK BUILDING CONTRACTOR Size Sq. Ft. Foundation # Rooms # Stories Height Occupancy Permit Class of Const. " HEATING CONTRACTOR Heat 0 AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR /?14~' Electric Servo New 0 Chang~ Temp 0 Type~'Volts3u/ Amps /&-J Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR _WC _Ur _ CBasin _ San. Sewer _ Storm Sewer _ Water _Lav _WH _Sh _FDr _ L Tub _Disp _DW _SP _ WSoft _OF _BT _Sink Other _ Eject __SS FEES: Valuation $ 5rj[:. ' Permit Fee Paid $ ISSUED BY ~(~ Date / .3 ... ./' 4 ..0 ~>. Park Dedication $ -f bf-r:z?l"C/ 7'\ .?; qlrial/o.p. 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 # lp>-<e 3 c; I::I~ PERMIT NO. <f-3rs;-t., /?7~~ ELEC. CONTR. / /:30 ,APPL. OATEr~o c,"$'? r OWNER ADDRESS' -I'{)J~ ~~~ l'i~~ : NATUR!' '..?F WORK _ f"'\i.:.~ ELEC.~DV~' NEW (-es~T6~ TEMP. OESC. TYPE' o//rL VOLTS ?ul AMPS /&-i> FIX'S SW'S RECEPT'S CIRC'S APPLIANCES SIGNS NSP. ROUGH N EST. COST ,";:)? REMARKS SERVICE () PERMIT FEE s~ FINAL OATE PO ~ 7 't~53''11