HomeMy WebLinkAbout0009254-Electric (service change) CITY OF OSHKOSH N2 09254
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ,"PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 13 2_7 /t1 DA () S , PLAN NO.
OWNER A4 th-r.
DESIGNER
USE /NATURE OF WORK Ciii.4\84-. s2 tj c- .
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 CG C. K A IC.
a
Electric Serv. New ❑ Change /Temp ❑ Type ( (A2 Voitse yo Amps iLD0
Fixtures Switches Receptacles Circuits ,� Oa c
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 $ • °C) Permit Fee Paid $ 2-0 e 00 ✓ Park Dedication $
ISSUED BY '717 Date - ! —7, — Final /O.P. g - a. 9 - r
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE I?„..cz L.) Z G- —
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #
PERMIT NO L APPL. DATE
ELEC. CONTR. ./�ir/s#1Pr
OWNER_'
ADDRESS 7 - 9,1 Q
NATURE OF WORK
ELEC. SERV. NEW
DESC. TYPE - / • -14.-- VOLTS VOLTS PS 40
FIX'S SW'S RECEPT S / C C'S 6
APPLIANCES
SIGNS 1
rrnrra
SP. ROUGHIN SERVICE ✓
EST COST "0-4.: " �� FINA ; t�B'�
REMARKS FEE �� DATE PD - 88