HomeMy WebLinkAbout015515 - Electric (chg svc) CITY OF OSHKOSH N°_ 15515
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC,"PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS
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OWNER L--0(')&,i
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DESIGNER
USE/NATURE OF WORK �Y.LeL /I C'e---
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 - e',----1`4-r K-/ '`-"-11--4
Electric Serv. New ❑ Change X Temp ❑ Type_ . Lr€Volts 3-1Q Amps/I 0 0
Fixtures — Switches Receptacles Circuits t/ �_`
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
,Co • Park Dedication $
FEES: Valuation $ QL! Permit Fee Paid $ ` /
ISSUED B Y Date /�- l- _f J Final/O.P. U -3t ! 7C
In the performance of this work I agree to perform all work pursuar,_ :o rules governing the described construction.
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SIGNATURES AGENT/OWN ATE
ADDRESS TELEPHONE#
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100,00•Joiljoll:' '' ‘°' w gPt• 31,
?EMIT NCI .
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OWNER ' ' ,C....4.--t-A--ei-e. , • UM .. '
NATURE OF WORK
ERV. NEW CHANGE .:... , TEMP.
• c. VOLTS /7' --:7 .4 0 AMP lG"' Ci
FIX' S SW' S RECEPT' S .., CIRC' S ■•,.
SG ROUGH N t •
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N P. ERVICE 1 • f; ' .
----- PERMIT FEE e - ---- DATE PD"* --/
REMARKS