HomeMy WebLinkAbout0041613-Electric (service change) (,3 tp
CITY OF OSHKOSH N � 41613
P ERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC
X PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT jueo_th
ADDRESS � PLAN NO.
OWNER ,- . .#i � .4
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 G7'
Electric Serv. New ❑ Change Temp ❑ Type % Volts 36 0 Amps d o
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 3 00 . 4 O Permit Fee Paid $ /1"-s C v Park Dedication $
ISSUED BY � /�r�.C1� D a t e 9 y' /�/
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 GATE
ADDRESS
TELEPHONE #
PERMIT NO. 4/13 . APPL. DAT I� "l `
ELEC. CONTR.04
OWNER
ADDRESS / 9/( _ -
NATURE OF WORK
C. ERV. NEW TEMP. du
DESC. TYPE 6, • TS 3 C/ AMPS le
FIX'S SW RECEPT'S CIRC'S
APPLIANCES
SIGNS ✓
INSP. ROUGHIN SERVICE 7/4 f F INAL,If W
EST. COST 3 ®o PERMIT FEE ea .o o DATE PD. 9 /0/9f0
REMARKS