HomeMy WebLinkAbout0014395-Electric (service change) CITY OF OSHKOSH N°_ 14395
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC(PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS //6 / /46 faCe PLAN NO.
OWNER F)/ 6?-A-
DESIGNER
USE /NATURE OF WORK _/ F �. — eT/ — 4
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 —dr 1 L ♦ " ' I.( ..,0, .... _
Electric Serv. New ❑ ' Change Temp ❑ p Volt/, /_ Q Am.s � 0r
F
A:1
ixtures Switches 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
f , 9 f,
FEES: Valuation $ U it Fee Paid $ D Park Dedication $
ISSUED BY � Date 7 73 -2 7 Final /O.P. ? / ?
In the performance of 's k I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 61)7/75:7 / '1, �
AG WNER ( DATE ii
ADDRESS
TELEPHONE #
PERMIT NO. 1 93 91 . APPL . DAT7 2 7 / c? ter'
ELEC. CONTR. 71 ;/°1 L -C/ F%
A
OWNER ~i.7 LF' r Li1
/ Y '? -- 22-2 172.., i--6-
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE 04 - 3 a , 3 -- -- VOLTS r. • AMPS /6 0
FIX'S SW' S RECEP'1 S CIRC' S ..r
APPLIANCES ...
SIGNS ( 7,
INSP. ROUGHIN SERV' CE VP. F FINAL 7 - / It
EST. COST !.O O — PERMIT FEE 20 DATE PD7- 1.7-5.
REMARKS
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