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HomeMy WebLinkAbout0012637-Electric (service change) � CITY OF OSHKOSH No 12637 `' PERMIT — PLICATION AND RECORD TYPE: BLDG ❑ HTG LEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ADDRESS 20 � � PLAN NO. OWNER �� ��%'S/ DESIGNER USE/NATURE OF WORK �� G '� �— �D � 3 ~ / � � 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 � C � " � ��5 � slectric Serv. New ❑ Change Temp ❑ Typ� Volt�� Amp,a�i�.� : /� p.� , 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 $ J ��I t Park Dedication $ ISSUED BY Date � �,3 � � �� Final/O.P. �l ` � � �/ In the performance of this rk I agre o perfo m all work pursuant to rules governing the described construction. SIGNATURE � 1� /^�� AGENT/OWN DATE � ADDRESS TELEPHONE N / � PERMIT I�10. f, APPL. DATE "� ' ��I � ELEC. COI�ITR. l�-� � �� LL` Z2 ; � OWTNER � � ADDRESS � C-J� `J - ✓'/-��u-�� - NATURE OF WORK , ELEC. SERV. I�IEW CHAI�GE - TEMP. DESC. TYPE - - ti/ VOLTS }" .� -�� AMpg ��> �'J FIX' S �_ SW' S RECEPT S CIRC' S APPLIANCES SIGNS <-". � .. INSP. ROUGHIN �� SERVIC�" ' FINAL' � � ` EST. COST S�'D`� PERMIT FEE '��%�DATE PD 3� 89 REMARKS � j . a '