HomeMy WebLinkAbout0015505-Electric (service change) CITY OF OSHKOSH N2 15505
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELECX PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 11 L 1
. . PLAN NO.
OWNER p / {
DESIGNER
dVil � LL ��,yy�� ,, // USE /NATURE OF WORK �JI�ULVi .- J /c 6 ' 3 C G `//-
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 • Li f .I . -
Electric Serv. New ❑ Change y Temp ❑ Typil ii Volt "2 tebAmps - 6, /l
Fixtures Switches Receptacles k.... Circuits
ID-- f
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 e (--- )
FEES: Valuation $ Permit Fee Paid $ �� Park Dedication $
,� ��` R �
ISSUED BY .- . % / �C`� Date /9 - 7 7 F /O.P.
In the performance of this k I agree to perform all work pursuan :o rules governing the described construction.
SIGNATURE 4/M //S /5 AGENT /OWNER D
ADDRESS
TELEPHONE #
PERMIT NO. l / . AP - s 15 -73
E
ELEC. CONTR.
OWNER � CG''.''
ADDRESS 5 `t 'i
NATURE OF WORK l g
ZLEC. SERV. NEW CHANGE TEMP .
DESC . TYPE j / 0 0 ..-7cr 3 — Lc/ VOLTS ! a- / v AMPS ..Z" a
FIX'S SW'S RECEPT P\ CIRC '
APPLIANCES
SIGNS l k `
INSP ROUGHIN SERVI CEV( FINAL 9 `/s - ft
EST. COST e a .►i. PERMIT FEE 3T ATE PD.7
REMARKS