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HomeMy WebLinkAbout0003515-Electric (service change) � CITY OF OSHKOSH No 03515 `' PERMIT — APPLICATION AND RECORD TYPE: BLDG ❑ HTG�ELEC�PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS � �/ //V ��% PLAN NO. OWNER � � � Y°` DESIGNER USE/NATURE OF WORK � f'Y �C � ' �/h,���y� 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 ��_�[�°�/� Electric Serv. New ❑ Change �"Temp ❑ Type_� Volts�`/V Amps L� 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: Valuation $ Permit Fee Paid $ � Park Dedication $ ISSUED BY Date��`U Final/O.P. � '-` °� ��/ In the performance of this work I agree perform all work pursuant to rules governing the described construction. SIGNATURE � ''�J�� AGENT/OWNER DATE � ADDRESS TELEPHONE# E `` PERMIT NO. � 3��`� APPL. DATE ,j -� --� � E LE C. CON T R. Qci�l�/' C��Z� {sT OWNER ` ADDRESS ' f�� f —�u�— ��i ' NATURE OF WORK ��--� ,�� - ELEC. SEf�V. NEW CHANGE DESC. TYPE -.3 !� L� 3 --c,t0 VOLTS j.?y���� �P_• _ C FIX' S RECEP � CIRC' S � APPLIANCES � SIGNS ` INSP. ROUGHIN SERVIC � �,. FINAL - -S7 EXT. COST C�� -� PERMIT FEE �D TE P �j -k� REMARKS