HomeMy WebLinkAbout0004861-Electric (service change) � CITY OF OSHKOSH N°_ 04861
`' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / �� ��—����� PLAN NO.
`~ ���.:.�V"L�-�--S �
OWNER L L � I
DESIGNER
USE/NATURE OF WORK ��� � t 1 C�� _
BUILDING CONI�RACTOR —
Size Sq. Ft. # Rooms # Stories Height —
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ FueliSystem Heat Loss BTU'S
ELECTRIC CONTRACTOR ��1�� LI�-�=1`�`��� � �
Electric Serv. New ❑ Change � Temp ❑ Type� Volts Amps�
Fixtures Switches� Receptacles—_,�— Circuits� /��� .
i �
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 � �T7 FinaUO.P. u "�� '��
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE � ��''"� � ��t c"�� • ��� �v �
AGENT/OWNER DATE
ADDRESS
TELEPHONE#
#
Electrical Inspection Department
Oshkosh, Wisconsin
Certificate of Electrical Inspeation r. �
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This is to Certify, that the ctrical Work Installed by 1 �'��•..�^"Q"
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in the premises of ��.�`/'`� 't✓ ��"L�.���� at No. / p�4� ' ��/''.��{
is approved under an ordinance entitled, "An ordinance regulating the install�tion of electric work,
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electric wiring and apparatus in the City of Oshkosh." ��/�'"''�`'�%�--
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Dated � �� �� �'� �
`� /'s'�'= �.,�
� ElectricalInspector
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PERMIT NO. � ��� APPL. DATE � ����
�
ELEC. CONTR. ( � Z�,
. �
� OWNER
ADDRESS ` �� — �j�T��---
NATURE OF WORK
ELEC. SERVo NEW CH�NGE TEMP.
DESC e TYPE :rZ 'j > . -- 3 -� VOLTS ! Z �!1 AMPS' O C�
FIX'S S�'+1'S RECEPT'S CIRC'S
APPLIANCES � � o
SIGNS
INSP. ROUGHIN SERVICE�� %t`'�; FINAL�' '
EST_ COST 'd ` PERMIT FEE .��J�D?E PD`' -7
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