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HomeMy WebLinkAbout0001631-Electric (service change) � _ CITY OF OSHKOSH No _ 01631 PERMIT APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT _ � �G ,� - - - - - - - - - - - - - - - - - - - - - - PLANNO. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - � ADDRESS � OWNER � DESIGNER USE/NATURE OF WORK ` 3�' �— 3 ��T 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 FI FC'TRI(' (�nNTRAC'T(�R �_ Electric Serv. New ❑ Change Temp ❑ Type Volts Amps14 d Fixtures Switches Receptacles Circuits r 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 / d FEES: Valuation $ �ermit Fee Paid $ ��� Park Dedication $ ISSUED BY Date�� —�� —�� Final/O.P. � — -�Z '�� In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE � �d �Y �� AGENT WNER DATE ADDRESS TELEPHONE S � � PERMIT NO. � �� � / APPL. DATE / � �� �� � � ` � � ELEC. CONTR. �.� � � , § ,��'/J a � . �,�j OWNER 7���1 � � � E i € � ADDRESS D � - L�—�� � � NATURE OF WORK Y.� ` � � � ELEC. SERV. NEW CHANGE TEMP. � � � DESC. TYPE -- 3 �-c-�- VOLTS lz > �4 A[ypS� i FIX'S SW' S RECEPT' � CIRC' S� € � APPLIANCES E ; � SIGNS ; INSP. ROUGH SERVI C '9- ��g 4 r^INAL -?Y-8!o ` k EST. COST S�G�.._..�']?ERMIT FEE�-.,�� DATE PD �y� � REMARKS � � E i � y � �[] Y 3 � I �