HomeMy WebLinkAbout0036125-Electric (service change) � 3 S�
CITY OF OSHKOSH N° 36125
� PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC � PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /Z 3 le`' • O c�"�- PLAN NO.
OWNER �
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Sbries 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�Temp ❑ Type � � Volts�W 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
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FEES: Valuation $ �7 D�• O i7 �ermit Fee Paid $ S �• � J Park Dedication $
ISSUED BY Date ���i� 7��� Final/O.P.
In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE /� `-� ��� � �
A NT/OWNER � DATE �
ADDRESS
TELEPHONE N
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�� �� 125 . APPL DATE g�3
PERMIT NO. _
; ELEC CONTR li���p
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� OWNER
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i P,DDRESS /2-3 ��J � ��- � � —
j NATURE OF WORK
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� C. SERV. NEW Z TEP'IP•
3 D C. TYPE VOLTS t r� ANIPS / Q �
; FIX' S SW'S RECEPT' S CIRC'S
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APPL ANCES
; SIGNS ��:�r-a
� INSP. ROUGH N SERVICE FIN
� EST. COST 0 � o� PERMIT FEE `b• �'' DATE PD. 1 '�
REMARKS
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