HomeMy WebLinkAbout0009899-Electric (service change) CITY OF OSHKOSH N2 09899
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / R y �r -rli PLAN NO.
OWNER ' `
DESIGNER
/
USE /NATURE OF WORK � �_. .r _ �r //' �_: / - P
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 imp ❑ Typell Voltsc2 mps /6 6
Fixtures Switches Receptacles Circuits 9 (
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
,l�
FEES: Valuatio $ �a Permit Fee Paid $ SL- V Park Dedication $
ISSUED BY Date F - /lam -- gg Final /O.P. g' --
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE '( ` ail _ _ , ,
AGENT /OW R • TE
ADDRESS
TELEPHONE #
PERMIT NO. 1 9 r AP' L. • TE 2
ELEC. CONTR.
/
OWNER . e- fi‘
ADDRESS / 75- 41 -- ,,
NATURE OF WORK
ELEC. SERV. NEW CHANGEOS TEMP.
DESC. TYPE 3 ._ (o 0 3 -A.. VOLTS l"...=-' 't AMPS /
FIX' S RECEPT CIRC ' S f ''
APPLIANCES
SIGNS , %�'�y! ; - . -.
INSP ROUGHIN < . SERVI ' 1', . ' -y/ . .1 4 FIN
EST. COST 4 j D!" PERMIT FEE -26.....----DATE PD '- -Pr"
REMARKS
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