HomeMy WebLinkAbout0004653-Electric (service change) CITY OF OSHKOSH N°_ 04653
P ERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC K PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 1 1 0 q P o ex S PLAN NO.
OWNER OQnCIi -.-tA ek 1
DESIGNER
USE /NATURE OF WORK 0 Q GN s P(`1.J l t (N' ,e' a ' i - 10D
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 Lc r z __,e c k f i
Electric Serv. New El Change :A Temp ❑ Type " 4.'' • Vol}..)-Z`Amps CI' Fixtures Switches Receptacles Circuits ' h - �+
�
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
J FEES: Valuation $ r A . o ,---- Permit Fee Paid $ .� .5 a -- �" -
� 7-7-1-F7 .
Park Dedication $
ISSUED BY
..- 410 Date Fnal /O.P. ?— / ` 0
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 1 /z.4) ? AGENT /OWNER DATE
ADDRESS
TELEPHONE #
P.FhSI NO. ( C APPL. DATE /
ELEC. CONTR. (/
OWNER G' `/
ADDRESS
NATURE OF WORK
CHANGE TEMP . •
DES C. T YP E . NEW ! - y 4 10 AMPS / '
F IX' TYPE �' VOLTS 1 ' CIRC'S RECEPT'
FIX'S SW' $
APPLIANCES
SIGNS SERVICE Z FINAL?
ESSTT . COSS T �d - ' --
I. O PERMIT FEE 75 DATE PD —?/
. a"
REMARIS��//