HomeMy WebLinkAbout0009872-Electric (service change) CITY OF OSHKOSH N2 09872
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ' PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ) ( PQ ()S4'& PLAN NO.
OWNER D /t/l rcti IL, DESIGNER
USE /NATURE OF WORK 0f0.1.. LS5J1 (J I c SO / 0 0
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 r
Electric Serv. New ❑ Change -`temp ❑ Type SW___ Volts 209 Amps LOCI
Fixtures Switches Receptacles < Circuits a S
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 $ Jj CD • Permit Fee Paid $ ,-?..c(3-1-) 1/ Park Dedication $
ISSUED BY " Al/ig1. j �.,i o Date i< 5 lJ 7- Final /O.P. 7--
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 4 s AGENT /OWNER
DATE
ADDRESS
TELEPHONE #
PERMIT NO. a _ 77 ' ' P - • DA r
ELEC. CONTR.
OWNER
ADDRESS
OF WORK
ELEC. SERV. �rr CHANGE/3 TEMP.
DESC. Ty E ' -i4 9 3 VOLTS AMPS /'
FIX'S SW' S c RECEPT' CIRC' SOS
APPLIANCES V >
SIGNS Cc-- eC
- )
INSP . ROUGHIN SERVI CEfr 1-2J- 8G-E`INAL7-29 -67r,
EST. COST 4-54°' PERMIT FEE 5 — DATE PDf15
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