HomeMy WebLinkAbout0003436-Electric (service change) CITY OF OSHKOSH N2 03436
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECPLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / / �d `x L i•--e..._ PLAN NO.
OWNER /9615-6 7 e‘ ,..–e5.
DESIGNER
USE /NATURE OF WORK �.. _ t
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 €
Electric Serv. New ❑ Change [Temp ❑ Type Volts Amps 6 C
Fixtures Switches Receptacles Circuits
9)9^
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 $ 6 Permit Fee Paid $ ‘ Park Dedication $
ISSUED BY ve-i _ Date — /.1 — 77 Final /O.P. 3 - /7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction. . s 2 , - 1 I I i - g
/
SIGNATURE
�,rir.
r 'ENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. 3 i 3 ce APPL. DATE .}._ 76 - e- 7
i
ELEC. CONTR. .afagaLahro. _40
OWNER op //
!i % %i��L ...
41 ADDRESS / -2-Z /� DYl/`-P ,
NATURE OF WORK
ELEC. SERV. NEW HANGEA TEMP.
DES C. TYPE G2 -)Q.& ?-!v VOLTS / 2 � r -c AMPS /Do
FIX'S RECEPT �J CIRC' S
APPLIANCES
i
SIGNS 1"n7
INSP. ROUGHIN SERVICE'( -1z-07F NAL j /?- !
EXT. COST d4 �� PERMIT FEE 31 TE PD.y -a- 7
REMARKS
f