HomeMy WebLinkAbout005680 - Electric (chg svc) CITY OF OSHKOSH N°_ 05680
clo-- PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC 2PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
2 7 ,1/7 // 2/ f�,y, PLAN NO.
ADDRESS _ V 7 �'* �/" `J
'J� S J t, -9 /i �� C'_/J'GIS 4.17
OWNER //
DESIGNER -
USE/NATURE OF WORK C-/C:iy 4-e.-7-t-c_.-e ete-4, ___ e.4,-fd2-tZ-- '
BUILDING CONTRACTOR Height
Size Sq. Ft.
# Rooms # Stories g
Class of Const. Occupancy Permit
Foundation —
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel/System
Heat Loss BTU'S
ELECTRIC CONTRACTOR /17;-/-5-
ONTRACTOR K- T YP e y>Volts 1)6'44 Amps / 0
Electric Serv. New ❑ Change Temp ❑
Fixtures
Switches. Receptacles X Circuits_ __— 17/ .Q --*
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
-� Park Dedication $
FEES: Valuation $ ,�A. " rermit Fee Paid $ J �$ r 7^-/
Date 9 —,� '4(1 Final/O.P.
ISSUED BY�
In the performance of this work I agree •erform all work pursuant to rules governing the described construction.
SIGNATURE—
II - ■ "" - ��_ DATE
/� AGENT,OWNER
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ADDRESS TELEPHONE#
PERI1/11 r, ,ji/6
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NATURE
OF WORK
E C. SERV. ���-,E,�
DESC. TYPE NEW
F'IX'S MANGE
APPLIANCES SW'S y VOLTS / �- TEMP,
RECEPT' AMPS l eG
SIGNS CIRC'S
INSP, ROUGHIN
fir .goare
SST. COST
SST. KS °o SERVIC ,Ji
PERMIT FE �- ��•
DATE PD /,fo""�',