HomeMy WebLinkAbout033413 - Electric (svc chg) X11
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD N2 33413
TYPE: BLDG ❑ HTG ❑ ELEC (3 'LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS I 5j-`S
O
WNER V°V S C `t Lt P S S/t c_
DESIGNER
USE/NATURE OF WORK _ L, ,_
C t' C .4 ,e,.,- - C ti
BUILDING CONTRACTOR
Size Sq. Ft.
# Rooms # Stories Height
Foundation
Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C El Vent Loss BTU'S Vent ❑ Fuel/System -
ELECTRIC CONTRACTOR/L-1 7 / 4( L / ,c- C.
0 cC Amps(&(*)Electric Serv. New ❑ Change Q'�ernp ❑ Type Volts/ p e-g
Fixtures
Switches Receptacles Circuits
PLUMBING CONTRACTOR
BT WH —Disp WSoft CBasin
_Lay
Sh DW DF San. Sewer
WC FDr —SP Ur Storm Sewer
_Sink
LTub Eject —SS —Water
Other
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t'"`- Permit Fee Paid $ � Park Dedication $ p
FEES: Valuation $ / 9 _��_!�
ISSUED BY :7-7 Date _/ Z 7-) Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE /4 t ont-ti-i--`% �� �_ DATE
AGENT/OWNER
ADDRESS TELEPHONE#
PERMIT NO• APP . !ATE
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ELEC. CONTR. ;
OWNER
aDIi" S
NATURE OF WORK
NEW CHANGE" � � AMPS. d
C. SEPV. - -;i; VOLTS .z ` CIRC' S
D FIX' TYPE 3SW' S RECEPT' S •
FIX' S
APPLIANCES `���j� !,
FIN
SIGNS SERVICE"�� DAT 'D. /a-9
ST. OSTGH N O-� PERMIT FEE
EST. COST
REMARKS
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