HomeMy WebLinkAbout0003387-Electric (service change) CITY OF OSHKOSH No 03387
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC(PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS gbs Lc--)--- PLAN NO.
OWNER I /i . rh4/1
DESIGNER �J/�
USE /NATURE OF WORK ? 4/ P O 0 A " ` P — i -r i
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 � Gka( Qs) ( ��Pcr C l . ��
Electric Serv. New ❑ Change Temp ❑ Type Volts Ampps . O
�" \
Fixtures Switches Receptacles Circuits .>< 0 r
"0
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS _ Water
Other
FEES: Valuation $ # 00 % 627 Permit Fee Paid ..� `
a d $ g Park Dedication $
i
ISSUED BY / /.►...laglif- /ime Date 4 / ' ---70 g7 Final /O.P. J — 3e 1' `O 7
In the performanc of this work I agree to perform all work pursuant to rules governing the described construction.
ei_c_cLer d SIGNATURE �� _ / 7
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. & ) 3 K7 APPL. DATE -2 y
ELEC. CONTR.
OWNER 'G 1
ADDRESS rd 5 i
NATURE OF WORK
ELEC. SERV. NEW CHANGE ' TEMP .
DESC. TYPE . - 3 - w - Ulm VOLTS ! z Y4 AMPS.2_e
FIX'S RECEPTS 4=< CIRC' S�
APPLIANCES r Yieee) et
SIGNS
INSP . ROUGHIN SERVI 3 $ `` 7 FINALS ' 3e) 47
EXT. COST j�S `-� PERMIT FEE
REMARKS
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