HomeMy WebLinkAbout0011576-Electric (service change) CITY OF OSHKOSH No 11576
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /k 4(2- ../977.14 .rol....1 -/ -4 PLAN NO.
OWNER /Z 1e__,�f( c =
DESIGNER
USE /NATURE OF WORK /4nrc-c c 6 ,7 -.5 o-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 ���'/��r i(
Electric Serv. New ❑ Change Temp ❑ Type Volts �Y Li. Amps /6 C.3
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 $ 7 O Permit Fee Paid $ .3- 5-94 - --/----- Park Dedication $
ISSUED BY d// • s- — Date � .2 ` 7 Final /O.P. `/5/4"
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE aZ ../
AG /OW ER / D TE
ADDRESS
TELEPHONE #
PERMIT NO. / / S APPL . DATE l -77
ELEC. CONTR. P
OWNER
ADDRESS
NATURE OF WORK
ELEC. SERV. NEW CHANGE vS TEMP.
DESC. VOLTS / 2 AMPS/c
FIX'S SW' S RECEPT''S CIRC' S D<
APPLIANCES
SIGNS ( t�Cee.. e )
INSP. ROUGHIN ,G SERVICED /9 FINAL 5 f - '/
EST. COST 70d /� PERMIT FEE y 5 PD/..2
REMARKS