HomeMy WebLinkAbout02421 - Electric (service change) CITY OF OSHKOSH No 02421
`' PERMIT — APPLICATION AND RECORD
TYPE: BLDG [] HTG ❑ ELEC taPLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS / 2 /'7-L _ :i.„,_c,--,( PLAN NO.
OWNER JC--- —,..._,Z
DESIGNER
USE/NATURE OF WORK --r'L 1.)-z- a�.� . --
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 �/ �
Electric Serv. New ❑ Change ETemp ❑ Type el Volts - 'C) Amps -2e) C
Fixtures Switches Receptacles Circuits `� \
QC
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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 $_ _ o� Permit Fee Paid $ Iy` r� Park Dedication $
ISSUED BY 'III �� // 7� /2—f.` �-
711 Date l� Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ��_-e -�L /, Cj C
AGENT/OWNER
ADDRESS
TELEPHONE#
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wli I/P
l PEMT NO o DATA /2 4.' 5 -7
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EL!CI CONTR. ,
OWNER p�, J
ADDRESS
NATURE OF WORK
ELEC. SERV CHANGE ac TEMP.
DESC. TYPE -p'?0 it`d ) -4- - VOLTS }cr?-7 44 G AMPS �c>
FIX'S RECEPT'S CIRC'S A
APPLIANCES ,
SIGNS
INSP. ROUGHIN Ot, SERVICE C/(-!3 `C`Sq(, FINAL/.2 17-ii.
EST. COST j-5-c - PERMIT FEE 9 s"-DATE PD.l,2-l7-4
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