HomeMy WebLinkAbout0043806-Electric (service change) o Ci354
CITY OF OSHKOSH N- 43806
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELE7PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 0-3 PLAN NO.
OWNER CZA.Tl
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Fourdation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR /7
,
Electric Serv. New ❑ Change / Temp ❑ Type ' //� Volts. Amps `g
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 $ 7 ,o ° Permit Fee Paid $ 3 5 -. 1 Park Dedication
ISSUED BY _ _ . y r Date �� /ri
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 DATE
ADDRESS
TELEPHONE #
PERMIT NO. V3(5 Oh . APPL. DATE
ELEC. CONTR. w
I
OWNER 1 2 � 11-✓
ADDRESS / 3 3
NATURE OF WORK
ELEC. SERV. NEW C N TEMP .
0 - �O AMPS 1
DESC. TYPE / CIRC' S
FIX'S SW'S RECEPT'S
APPLIANCES
SIGNS
INSP. ROUGHIN SERVICE t /S9'f F INALfr "
EST. COST ?o 0 PERMIT FEE �j!� DATE PD.27/ /9
REMARKS