HomeMy WebLinkAbout012346 - Electric (change svc) CITY OF OSHKOSH No 12346
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC.X PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /O 3 I " )-iii-t(-1-1--11.14--\__ PLAN NO.
OWNER 6:)..44.----
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DESIGNER
USE/NATURE OF WORK C ' W '-t^ t--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 CONTRACTO• —. . d ?fr -6- c .
Electric Serv. Ne • Change X Temp ❑ Typ/ Volts / ° Amps 1e0
Fixtures Switches Receptacles Circuits DEC
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
•
FEES: Valuation $ /' Permit Fee Paid $ ,,,Z ' Park Dedication $
ISSUED BY Date A ` /3 -FY Final/O.P. /—/---2- 2
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE ; <<r � ` +�
7
AGENT/OWNER DATE
ADDRESS
TELEPHONE#
PERMIT NO./A__3 /6 > APPL. DATE / '7
ELEC. CONTR. %-- �7n 7 ",-�� z%
OWNER '1/- �-_ 0,--J L.- z,<
ADDRESS / 6 - A/I-' -- -'� J
NATURE OF WORK
ELEC. SERV. NEW CHANGE OC TEMP.
DESC. TYPE 5-/ O • • 1-cc- VOLTS i -' 5`o AMPS / U G
FIX'S RECEPT'S CIRC'S D(
APPLIANCES 4.Q.P
SIGNS C 6ti.,x C'ef-)
INSP. ROUGHIN SERVICE C�/•�-/-i2 ��FINAL /-/2-=g9
EST. COST j-..< `! PERMIT FEE vZ 6' DATE P2�� LW
REMARKS D.