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HomeMy WebLinkAbout0010825-Electric (service change) � CITY OF OSHKOSH N� 10825 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC Q�PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS G' � �O w • � �'` /�v2 . PLAN NO. OWNER_ .� �;i !i-•��I� � r� !� /+ M 1'" ;t..J �C2 -,� ` � DESIGNER USE/NATURE OF WORK— C 1� a✓. c � $�r'�i.r ,t e� /� � C. �,,�.��.•¢ 3 - (o r� 3 — i p c% 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 C, li��� � L l Q c �n,' � Electric Serv. New ❑ Change � Temp ❑ Type - `•� Volts � Z�'v Amps� �� Fixtures Switches � Receptacles Circuits � � PLUMBING CONTRACTOR —BT _WH _Disp _WSoft —CBasin —Lav _Sh _DW _DF —San. Sewer —WC _FDr _SP _Ur _Storm Sewer —Sink _LTub —Eject _SS _Water Other FEES: Valuati $ � � '--Permit Fee Paid $ v '� Park Dedication $ ISSUED BY Date�[� � �—�� Final/O.P. /D " �� -�a In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE C.�t� `��G����` �'v�7 `�� AGENT/OWNER DATE ' ADDRESS TELEPHONE# PERMIT NO. D �2 APPL. DATE l � - �/'��O ELEC. CONTR. /�-�ivZ'L ��� , OWNER V� �- � / /�( ADDRESS lJ� � � � - ��Z� / � NATURE OF WORK ELEC. SERV. NEW CHANGE TEMP. DESC. TYPE 3 � D -� VOLTS � ��E U AMP FIX'_S SW' S ,�,�' RECEPT S " CIRC' S� APPLIANCES SIGNS INSP. ROUGHIN SERVICEO/�l-1D�;_l� S�rINAL/D-�I�FS : EST_ COST �� O� PERMIT FEE y D J DATE PD 0-�- R.EMARKS � �