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HomeMy WebLinkAbout0011203-Electric (service change) CITY OF OSHKOSH No 11203 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC V PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ADDRESS 2-3c V v . 17 Al) -.— PLAN NO. OWNER A) or C ooCXNc.- , DESIGNER USE /NATURE OF WORK S`zAr L ) )C/ �i`- i C0( AMP To /0 Q ,}M p ` l _ 1(‘e ci IT 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 5'ec-t 14 r e7.e c_ iv L Co Electric Serv. New ❑ Change Temp ❑ Type 3 41/e -c Volts 23 Amps ] 4" Fixtures Switches Receptacles X Circuits '' \ o 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 d s . FEES: Valuation $ ?AO • Permit Fee Paid $ LYS 2-0.--- Park Dedication $ 1. ISSUED BY f Date // /‘? / —'/ -F �/ ` In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE f,i-a4t Gt g e t%! �� //r� ia �l! 0 AGENT /OWNER TE ADDRESS TELEPHONE # PERMIT NO. 1/; APPL. _BATE 41 F ELEC. CONTR. ,4 01111681r OWNER � A / � �� ADDRESS LC/ -7 7 i NATURE OF WORK r ELEC. SERV. NEW CHANGE D‹ TEMP. DE$C. TYPE 3 -,O 3 w VOLTS 'td AMPS l © O FIX'S p` SW'S oC RECEPT'S K CIRC'S% APPLIANCES SIGNS l te INSP. ROUGHIN �3 IC'il ° � �ISERVICE .I e o � ` � I FINAL EST. COST C7 dO PERMIT FEE 35 -- DATE PD.I WO REMARKS