HomeMy WebLinkAbout0010514-Electric (service change) CITY OF OSHKOSH No 10514
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 7 3 1 )Jjf-zz •� PLAN NO.
OWNER V Eye- /3
DESIGNER
USE /NATURE OF WORK _ ` • -E.--
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 (U r /7 4 /e c' p l e
Electric Serv. New ❑ Change Temp ❑ Type #1,7 Volts 3 , Am s D a
Fixtures Switches Receptacles Circuits 9;LO .
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
56 , ` "� .2'(-' �' I/ FEES: Valuation $ Permit Fee P aid $ Park Dedication $
ISSUED BY Dated -- 2a - '7 Final /O.P. 7-/ i r-"- 7: 7-
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE /0 ' ,/ '
Vz a �e AGENT /OWN :� ATE E
ADDRESS
TELEPHONE #
PERMIT NO. 1 O PAP. DATE —/7- .--
ELEC. CONTR. w
�!� -
OWNER j
ADDRESS ` - ��
NATURE OF W6RK
S`
CHANGE TEMP.
ELEC. SERV. NEW Le., VOLTS PS ASS / �
DISC. TYPE RECEPT'�S 5 CIRC' S OS
FIX'S V APPLIANCES
CL I 0 1
SIGNS _
INSP . ROUGHIN______ SERVI CE 4/- X - 1 Fr FIN it t
EST
. �
EST. COST �`--� PERMIT FEE DATE PD1-2
REMARKS ., god q/
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