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HomeMy WebLinkAbout0016169-Electric (service change) ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 16169 TYPE: BLDG 0 HTG 0 ELEC ~BG 0 SIGN 0 ZONING FLOOD PLAIN HEIGHT DESIGNER ~"'-""'-r'C- . / ~~' d~' PLAN NO. OWNER ~ ADDRESS USE/NATURE OF WORK ~3 - 6 {J;?i; ;3 "~/CJO BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. HEATING CONTRACTOR Heat 0 NC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR ,~~Y / t!)-V -/ )0 - C-.-;:-L- Cl Electric Servo New ~hange ~mp 0 Type _ Volts _ Amps_ Fixtures ~witches -Receptacles c;...----" Circuits "-- v 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 FEES: Valuation $ ISSUED BY p. , Permit Fee Paid $ Date 35~ //~;2 ~7J? Park Dedication $ Final/O.P. /6J-1f -77 SIGNATURE I agree to perform all work pursuant to rules governing the described construction. ~ dtf'J G' T/OWNER ./ DATE / ADDRESS TELEPHONE # ;? -:;; 9-Y2 ELEC. CONTR. ADDRESS ~ATURE OF WORK EC. SERVo D,SC. TYPE ~IX' S DZ.. APPLIANCES S I'GNS INSP. ROUGBIN EST. COST F7 0'0 ~ REMARKS = ;;2') f .>-- N~ / . .~ . ", CHANGE / " VOLTS I RECEP · S = OWNER SERVIC PERMIT FEE = TEMP. AMES I CIRC'S ~ ~