HomeMy WebLinkAbout0020283-Electric (service change) CITY OF OSHKOSH N2 20283
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC, PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /73,
f
Y3 ' PLAN NO.
OWNER ! l (--
DESIGNER
USE /NATURE OF WORK ei.,47 ra-e--- ,
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System 3 Heat Loss BTU'S
_ ' N t-%( // f G a-- E. t * e G`A^ e c
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change irg(Temp ❑ Type ' Volts ��- Amps /e 0
Fixtures Switches Receptacles ___(›C Circuits f
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: Valuati.n $ .... Permit Fee Paid $ . ' �i Park Dedication $
ISSUED BY 4 / ! -� Date / —6 I C S Final /O.P. 9- le - 96
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE C.--0-4.--e //WO"' / / 9 e,
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO.
�C/ APPL . DATE 9 .1.-- 9 a
r -
ELEC. CONTR. ' -' �i/
.-/:-/4
OWNER. / /10r 1 .
`
ADDRE S 93 , - - e
NATURE OF WORK
E CHANGE' TEMP.
SERV. NEW `
D C. TYPE - / i u/ VOLTS I - 3 lAv CIRC S
FIX'S SW ' S RECEP 'S .
AP AN S V
SIGN SERVICE`S' N��
EST. COST
INSP. ROUGH N QOo_ pERMIT FEE 5-- DATE PD. -- " ye
REMARKS
r