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HomeMy WebLinkAbout0026416-Electric (service change) � CITY OF OSHKOSH N° 26416 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS ` � � PLAN NO. OWNER_ �� U � L�� / DESIGNER USE/NATURE OF WORK � ,3 -� �D � 3 ld� : BUILDING CON7'RACTOR 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_ �� Z- t -C � 'e � � "L Electric Serv. New ❑ Change � Temp ❑ Type� Volts � � 4�mps ���� Frxtures 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: Valuation $ ZQ�'��Permit Fee Paid $ / � �`�- Park Dedication $ ISSUED BY Date �� ``1' Final/O.P. - / � -Z� -`1 � In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE � � 9 � AGENT/OWNER DAT ADDRESS TELEPHONE# � � � � - - � , � PERMIT NO� �i� , APPL DATE l� —� `� `�� ; 3 � C � ELEC. CONTR. �V � � �. �( � OWNER . � f s :3 ADDRESS � �� � • Zf/ 1 ���` � � NATURE OF WORK _ _ � � , � EC. ERV. NEW CHANGE TE�• � ' C. TYPE — s� �VOLTS � �fD A.i�S a' � ? FIX' S SW'S RECEP S OS CIRC' S .{� � ; APPT TANCES � � � I� � � f NSP. ROUGH N S ERVI C "� �`� - F INAL 2� '-t— � ' EST. COST /PERMIT FEE � DATE PD — e � ; REMARKS � D � "f AS j S