HomeMy WebLinkAbout0042214-Electric (service change) No �-��
/� CITY OF OSHKOSH - 42214
`'' PERIUIIT -- APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS /��Q ���.�� PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK
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�� Amp���
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 $ �� ��O Permit Fee Paid $ ��� `�� Park Dedication $
ISSUED BY �^' ^ Date ������ FinaUO.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE � �
AGENT/OWNER A�
ADDRES5
TELEPHONE#
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�, Z( . P,PPL DATE ��� °!��
PERMIT NO. —
ELEC. CONTR.
OWNER
ADDRESS /�� d ��-��'��-
N.ATURE OF WORK
ELEC. SERV. NEW `7 ��'
DESC. TYPE VOLTS Ai�S ov
FIX' S SW' S RECEPT' S CIRC' S
APPLIANCES
4
SIGNS
INSP. ROUGH N SERVICE S� S Y FINAL '6N r
EST. COST � C.� PERMIT FEE � .0 � DATE PD. v `j
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