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HomeMy WebLinkAbout0035023-Electric (service change) � �� � CITY OF OSHKOSH N°- 35023 : PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ` � �ti ADDRESS �� � /� �'l " �' PLAN NO. OWNER L-- DESIGNER USE/NATURE OF WORK Z. �� - � � ��� 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 1 ELECTRIC CONTRACTOR /N l Z' -t � �' � �� �,� � Electric Serv. New ❑ Change J� Temp ❑ Type�� Volt�Z � �mps�� 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 a._-- . FEES: Valuati n , 4�� Permit Fee Paid $ ���� Park Dedication $ ISSUED BY � Date , ^���3 Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE / �. � �� —,� AGENT/O R pA� ADDRESS TELEPHONE# t ; PERMIT NO. ����� � •�p • DATE /� � ELEC. CONTR. � � OWNER � , ADDRESS ,�3 ` � � �� '� r NATURE OF WORK __ � r C. SERV. NEW CHP►N TE1KP• ; C. TYPE - O 4� VOLTS �- z-`� AI�S O ; FIX' S SW'S RECEPT CIRC'S ; AAPLIANCES � SIGNS - NSP. ROUGH N SERVICE FINAL ` EST COST /d / PERMIT FEE S O./ DATE PD. ��'� j REMARKS _ �