HomeMy WebLinkAbout0036348-Electric (service change) Co 3 5'
/CITY OF OSHKOSH N ° - 36348
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC IN PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /4 3 9 / o-C.' 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 p- efz iic,ci
Electric Serv. New ❑ Change At Temp ❑ Type 0 / , Volts 34(1 Amps/0 0
Fixtures Switches Receptacles Circuits
act de
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 $ Fo a 0 ' , n T
Permit Fee Paid $ 3 S 4 Park Dedication $
G ISSUED BY 4....e, Date / 3 Final /O.P. /d/7/ 3.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATU .?.l . / �-4 o -/3- 3
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #
PERMIT NO . 3 T r . APPL . DATE / C / S
ELEC. CONTR.
OWNER
C
'ADDRESS k0 3 9 //7‘,.7.1z4
NATURE OF WORK
ERV. NEW ANGE) TEMP.
DESC. TYPE VOLTS AMPS
FIX'S SW'S RECEPT'S CIRC'S
APPLIANCES aCA LtA.
SIGNS V
IN P. - OUGH N ERVICE , 3 FINAL
EST. COST 0 o PERMIT FEE 3 DATE PD. /b /3 - 3
REMARKS
r