HomeMy WebLinkAbout0042835-Electric (service change) No 63Si
CITY OF OSHKOSH 42835
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /i° 3 PLAN NO.
OWNER 9d u.4l
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 64 -,4-1-4 re/€2Ccle 8) Ct -G
Electric Serv. New ❑ Change 13( Temp ❑ Type Volts 3 U. Amps
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 $ 3790. ca 0 Permit Fee Paid $ 20. U / Park Dedication $
ISSUED BY ,.r.�.l./.wi--- Date /f /4_— y Final /O.P.
In the performance of this wor agree to p= orm all work pur • • t to rules governing the described construction.
SIGNATURE � if� ' 1 AlO ,
AGENT /OWNER DATE
ADDRESS
TELEPHONE •
PER NO S d 3 S 6 3
• APPL .
E C. CONTR. 1
OWNER A GctA.
ADDRESS Q C7
NATURE OF WORK
. SERV. NEW Ots..ad 7 , v
C. TYPE I_ 1 • TEMP .
FIX'S SW'S RECEPT'S AMPS •
CES CIRC'S
N P . ROUGH N ER CE
E COST o o • v � �'4Y FIN •
R__MARK P RMIT FEE . o DATE PD./ y