HomeMy WebLinkAbout0024023-Electric (service change) CITY OF OSHKOSH N °a4a-2
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECX PLBG ❑ SIGN ❑ ZONING FL000 PLAIN HEIGHT
ADDRESS / l '// Y- Pc9--e-e"-y
PLAN NO
e
OWNER a di, '
DESIGNER
USE-NATURE OF WORK
64 ..-efe.‘ - //...2-1-1/
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ NC ❑ Vent ❑ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change II` Temp ❑ Type , ,- W Volts P }I . L enmps /19 OG _) O J
Fixtures //
4-..1
Switches Recept. cies a Circuits c
9 ,'
PLUMBING CONTRACTOR
_DT — WH _ Disp — WSoft — CBasin
_Lay — Sh — DW — DF San. Sewer
— WC _ FDr _SP — Ur _Storm Sewer
— Sink — LTub — Eject — SS _Water
Other
FEES: Valuation $ /� ' Permit Fee Paid $ % Park Dedication $
ISSUED BY Date Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules goveming the described construction.
SIGNATURE !' ,` J ^,,, ? ��•
f / AGENT /OWNER DATE
C
ADDRESS / / l 0 �ey - -/*c '‘.- /ry e'
TELEPHONE i
PERMIT NO. 2 4 3 PPL. DATE g �
ELEC. CONTR.
■
OWNER
ADDRESS / z 7 / 77
— � '
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC TYPE - 9 ® 3 — w VOLTS / AMPS /
FIX'S )- SW'S RECEPT' CIRC'S
APPLIANCES
SIGNS NO v_7-<
INSP. ROUGHI SERVICE ,/ a FINAL
EST. COST � 0C � � PERMIT FE 3 DATE PD.5 z? Vo
REMARKS
.771/ 2 ' - 89