HomeMy WebLinkAbout0013171-Electric (service change) CITY OF OSHKOSH No 1
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC k PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS C/ 7 0 Pir W ' I s PLAN NO.
OWNER PI7yJJ.. ; � A/e «-
DESIGNER
USE /NATURE OF WORK ire Z � N � // re
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 / L ��c� fG _ _ '° Ge'
r�
Electric Serv. New ❑ Change X Temp ❑ Type 1 : - .1*-.. Vo l�� Amps re
Fixtures Switches Receptacles / Circuits 6U7
%3 \
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 $ C C " Permit Fee Paid $ �_> Park Dedication $
ISSUED BY //�`� I -s:� % -tit Date Date - / c `7 Final /O.P. 1 7 1 " — e7-. 77
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
P , • , / / // f Yi17
r SIGNATURE ,Lil. /
f AGENT /OWNER / DATE
ADDRESS
TELEPHONE #
3 PERMIT NO. 7/ . . DATE 1- 7 -- 7P - Ty
'P Ty
ELEC. CONTR.
OWNER 47/ 77 7
ADDRESS 41 :57! o — (;���7
NATURE OF WORK
ELEC. SERV. NEW CHANGE DS TEMP.
DESC. TYPE ,2 - 3 c / ---- 7 -,-, -- - VOLTS I V- °-/ ° AMPS / a c
FIX'S RECEPT' !X CIRC'S
APPLIANCES j/
SIGNS f
INSP. ROUGHIN SERVICE' - FINAL L} -2C -i9
cfie-
ES . COST - PERMIT FEE - — D•TE PD. -
REMARKS
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