HomeMy WebLinkAbout0047217-Electric (service change) 63s
CITY OF OSHKOSH
NI 47217
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC,PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS t7._Y. / _ PLAN NO.
OWNER X:7, e .,,,.
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
Electric Serv. New ❑ Change Temp ❑ Typ e Volts t Amps/
Fixtures ''� �i
Switches ./ Receptacles - Circuits
PLUMBING CONTRACTOR
_ BT _ WH _ Disp _ WSoft — CBasin
- Lay _ Sh _ DW _ DF — San. Sewer
- WC _ FDr _ SP _ Ur — Storm Sewer
Sink _ LTub _ Eject _ SS — Water
Other
FEES: Valuation $ f O • 00 Permit Fee Paid $ . 6 ' C? a
Date(? J Park Dedication $
ISSUED BY Date / /9/9 A 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. y- 2 / 7 • APPL . DATE 7 /- r
ELEC. CONTR. ,efie—at.4.
OWNER
ADDRESS / 7 )4 7 j` .,t,,
NATQRE OF WORK
ELEC. SERV NEW cFtAN
DESC. TYPE 0 / V•
TEMP.
FIX' fSW' S � 1- „. APPLIANCES CEPT' ,i CIRC'S
,SIGNS
INSP. ROUGH/ SERVICE &'//4r FINAL
- • T
REMARKS F D < - • 9