HomeMy WebLinkAbout0009714-Electric (service change) CITY OF OSHKOSH N2 09714
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC 'a PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /
l d �, �`✓)'Le'- p PLAN NO.
OWNER ?" '''---
DESIGNER
USE /NATURE OF WORK (4 -&,, ---r -C - 3 p 3 -70c
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 1 _1 .L.,_ �.
/3
Electric Serv. New I Chang %Temp 111 Type�,e Volts 4 Amps / � d G
Fixtures Switches Receptacles A Circuits /
y,c......
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 $ OD Permit Fee Paid $ ` !� Park Dedication $ p
ISSUED BY Date 7 — U (J Final /O.P. 7 " /3-78'
O
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR
04
.r1 't-'' ft ...-- ? .-- AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO F// . AP • . DATE
ELEC. CONTR. ,
0
OWNER ;. -.e --F4
ADDRESS / e /0
NATURE OF WORK
ELEC, SERV. NEW CHANGE 9K TEMP.
DESC. TYPE . 3 - 6 — 3 VOLTS 4 d AMPS /
FIX' S
APPLIANCES SW S R CEPT' S CIRC' 5 kr/
SIGNS 1 ›.0
NSP. ROU SER D! - - l / 8 F ! -
EST. COST m ° PERMIT FEE. . DATE PT) - 9 - Z(
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