HomeMy WebLinkAbout0006962-Electric (service change)
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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
06962
TYPE:
BLDG D HTG D ELEC ptj PLBG D SIGN D ZONING
FLOOD PLAIN
HEIGHT
OWNER
Jb"'S2 ~
~~
PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK
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J~CJIf A4VU ~
/1;;"00 H ..:2 7~
r $;!,
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat D NC D Vent D Fuel/System
Heat Loss
BTU'S
r
~
J]
,,'. Electric Servo
I) ~ ~
~J V
Change I:z( Temp D
ELECTRIC CONTRACTOR
Typeove~folt~~mps /.a..oo .
()(
Circuits
1fP-
New D
Fixtures
Switches
Receptacles
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _OW _OF _ San. Sewer
_WC _FOr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
ISSUED BY
tJ (!J t) ~ Fee Paid $
Date
~Jj--~
'2 -./-g y-
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
~~
~ 3 -8?J;
AGENT/OWNER
DATE
ADDRESS
TELEPHONE #
.s
ELEC. SERV. NEW
pESC. TYPE'7~j,V~~ =&-;2. (!) V
FI X ~ S r SW.' S / () 00
APPLIANCES i
SIGNS .. ... ............. ...: ~~ . .
INSP. IlOUGHIN . .. SERVICE ~~~- - FINAL ~.
EST. COST ;r:0' C'V&~PERMI'l' FEE;Z3'r~DA'IEPD;)-}-'Off
REMARKS ,. . .. '. ;
ELEC. CONTR.
OWNER
ADDRESS
NATURE OF WORK
TEMP.
AMPS/-<ob
CIRC'S