HomeMy WebLinkAbout0044441-Electric (service change) CITY OF OSHKOSH NO 44441
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECPLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS Vz �A � PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR a 61
Electric Serv. New ❑ Change iKTemp ❑ Type Pi Volts3 al Amps,
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
— BT — WH — Disp — WSoft — CBasin
— Lav — Sh — DW — DF ._ San. Sewer
— WC — FDr — SP — Ur Storm Sewer
Sink — LTub — Eject — SS — Water
Other
FEES: Valuation $ 6O.0 . D v Permit Fee Paid $ 3f• o a Park Dedication $
ISSUED BY ,0//f
Date .s � Final/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 #
PERMIT NO. APPL. DATE
ELEC. CONTR
OWNER
ADDRESS
4/
NATURE OF WORK
SEC. SERV. NEW CHANGES Z i 3 0 TEMP .
D C. TYPE G • • AMPS 4'
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES
SIGNS
INSP. ROUGIN SERVICE FINAL
EST. COST (0") o . F) PERMIT FEE 3 $ DATE PD. S /f /7,y'
REMARKS