HomeMy WebLinkAbout0023493-Electric (service change) CITY OF OSHKOSH N° 23493
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 6 e 7
PLAN NO.
OWNER 1 -
DESIGNER
USE /NATURE OF WORK - ?'4 / .Z 3 /O
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ NC ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR Ms) e44, -
Electric Serv. New ❑ Change 9,T�emp ❑ Typg A ��
Vol '� Amps 6d
Fixtures Switches �c Receptacles Circuit
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
��`l � oc
FEES: Valuation $ Permit Fee Paid $ _ _ O Park Dedication $
ISSUED BY .�� Date -z F'`` /* Final /O.P. 1 1 — .2--
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE -ekZ��f9a 7 --p.
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PERMIT NO. 2 3I / ` APPL. DATE / "- 7
/
ELEC. ONTR. k .i• L.o
OWNER l
ADDRESS /7 7 `--- 61 ' 4 ,.'
NATURE OF WORK
ELEC. SERV. NEW CHANGE TEMP.
DESC. TYPE , 6 O 3 - { v VOLTS / �- � , c , AMPS / d a
FIX'S SW'S RECEPT S D` CIRC'S,?
APPLIANCES V
SIGNS CCe
SERVICEOK\ "' FINAL `/ - 2 - Y/
EST. OSTGHIN u� PERMIT FEE , — DATE PD 5
EST. COST , ��o REMARKS
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