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HomeMy WebLinkAbout0012167-Electric (service change) CITY OF OSHKOSH N° 12167 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC A PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ADDRESS .2 / D Z 41 / 1 i C A IJ 4 PLAN NO. 'I OWNER 2 N i-f -r ✓ -4t° 4 DESIGNER USE /NATURE OF WORK C c ' C h i `c a y _r/6c. - "3// U Q 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 Dok ' S C I-r r 4 ,'_, Electric Serv. New ❑ Change K Temp ❑ Type S w Volts 42 9 mps 70 a Fixtures Switches Receptacles Circuits y' � < P 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 cY C t FEES: Valuation $ 5 Permit Fee Paid $ �� ��✓ Park Dedication $ ISSUED BY Ae % %/ Date / -23 -/ ! Final /O.P. / s " - ')", ` G In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE /-22- S- 9 AGENT /OWNER DATE ADDRESS TELEPHONE # MIT NO. �` 6i APPL. DA E / l — OP PER �. ELEC. CONTR. OWNER , 4/ ADDRESS / - NATURE OF WORK ELEC. SERV. NEW CHANGE TEMP. DESC. TYPE - O 1 -4� VOLTS / 'f e AMPS /49 ° FIX'S SW'S RECEP S ' CIRC'S/� APPLIANCES V SIGNS _ INSP . ROUGHIN SERVICE © -/d `y-8 k FINAL / " EST. COST 445 ® PERMIT FEE oZ DATE PD. / -23 -8Y REMARKS