HomeMy WebLinkAbout0021084-Electric (service change) CITY OF OSHKOSH N2 21084
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC [PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS a--0 / C.► /Vj/iv Av of 0 '14 PLAN NO.
OWNER L.g 1'4 4,:C -e.--
DESIGNER
USE /NATURE OF WORK N e W $ -wit (i t ' e -e
3 -flee)
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 Do rt C s i A' e 1 C.....•
4
Electric Serv. New ❑ Change 2., Temp ❑ Type Volts/4 o Amps !o a
Fixtures Switches )'C Receptacles Circuits j<
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 $ ,/ ea -- Permit Fee Paid $ --"---_ Park Dedication $
ISSUED BY Date `Q OZ o.- — 7.0 Final /O.P. 1-57— ?'
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 4— /0 " 2 - e)
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
' • , APPL . DATE 7 PERMIT.NO. - /
f .-
ELEC. CONTR. AI. o' c' "'
se
�! _....ti . - A
OWNER i...
ADDRESS //46 ~
NATURE OF WORK
ELEC. SERV. NEW
CHANGER" TEMP.
DESC. TYPE f f'() .- , w VOLTS /. d �C S PC
FIX'S SW'S RECEPT' t 1 ' v
APPLIANCES
IGN
INSP. ROUGHIN S ERVI iggalliSI LIIIMMBi r
EST. COST e PERMIT EE . d i DATE PD /O•) 2 y0
REMARKS W (vfv
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