HomeMy WebLinkAbout046257 - Electric (Change service (08/25/95) 6
CITY OF OSHKOSH
N° 257
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ® PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /7z z /
PLAN NO.
OWNER 91-2-- -- W y./b r '
DESIGNER
USE/NATURE OF WORK
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 17t_i 1. ,Lt i--
Electric Serv. New ❑ Change,Temp ❑ Type Volts-z 6A-1 Amps /u'v
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 _
FEES: Valuation � e • e0 Permit Fee Paid $ S-6),/0_40 / Park Dedication $
ISSUED BY Date 2V Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER DATE
ADDRESS
TELEPHONE
-Z APPL DATE i
L L l���
PERMIT NO 'P �—
ELEC. CONTR.
OVER
ADDRESS
NATURE OF WORK _ TENS
AN AMpg o�
SERV. NEW VOLTS REP CIRC' S
. C, TYPE SW, S�' CET' S
FIX' S
AP LANCES ®r
SIGN ERVI l®L DATE PD.
ROUGH N
ESST T. o COST � v P RMIT F E o
REMARKS