HomeMy WebLinkAbout0024070-Electric (service change) CITY OF OSHKOSH N°_ 24070
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC, PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS vZ i PLAN NO.
OWNER hC
DESIGNER
USE /NATURE OF WORK T-G
3 - - 3 l o y
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 1_ a ' �
Electric Serv. New ❑ Change Temp ❑ Types) &. Voltt `f Amps a
Fixtures Switches 0< Receptacles Circuits
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: Valuatio $ 4 Q `-- Permit Fee Paid $ �� ' Park Dedication $
ISSUED BY Date 2 --- F/ Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE e% 1 ZA-A 74 2 I f/
AGENT/OWNER 1 DATE
ADDRESS / v" 2 - /Matiroe go/. c$4ksh kJ LWIO/ Gam' 3
TELEPHONE #
PERMIT NO ..2 Z 7Z' APPL DA 7 / ` /
ELEC. CONTR.
r'/?7°.izi"' /
OWNER / ADDRESS ` 3 �4 - ; 2 z
NATURE OF WORK
ELEC. SERV. NEW
CHANGE A TEMP .
DESC. TYPE 3- 60 :7fr 1 w RECT / S j Y CI AMPS
S
FIX'S SW S t,
APPLIANCES
SIGNS ERVICE/� '�" FINAL
INSP. ROUGHIN S
EST. COST 4 PERMIT FEE020 DATE PD.7 2 `2'
REMARKS
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