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HomeMy WebLinkAbout0032859-Electric (service change) C� �� � CITY OF OSHKOSH N°_ 32859 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ` - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS �-� � G' 1 PLAN NO. `,��. OWNER U1J� � �O� lG� DESIGNER � USE/NATURE OF WORK ��P��`T \ L�`-I �� -�-[? � /LP �J `r�B Q BUILDING CON7RACTOR 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 � 1� �-� � Electric Serv. New�Change � Temp ❑ Type Volts�� Amps�Q� %�!�(� � 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 : O� °-� °� �` � FEES: Valuation $ / Permit Fee Paid $ � � Park Dedication $ ISSUED BY Date � � `/ � Final/O.P. � � 3 rq � : � In the pertormance of this work I agree to perfo I� work pursuant to rules governing the described construction. i SIGNATURE � -�r� � AGENT NER DATE p� r� ADDRESS �Z- ! � i l�C-1� ��. Z� ( --�3 �°2'� TELEPHONE# PERMIT NO. � � �J � L. DATE --2 ��� ELEC. CONTR. '�~2� 'L�` OWNER ��v � '` P.DDRESS l � l � ` ��L%��-�'tti—� NATURE OF WORK EC. SERV. NEW CHANGE TEMP. D�F,.ZC'. TYPE ~ lP c,c� VOLTS Z � ANlPS l0 FIX' S SW' S RECEP S �� CIRC'S D'C__ APPLIANCES �/ � � , SIGNS � - ZNSP. ROUGHIN SERVICE � � FINAL - -- `l EST. COST C%C% --- PERMIT FEE d`=` DATE PD �'`f REMARKS � � I l � � i I I �