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HomeMy WebLinkAbout0001060-Electric (service change) � CITY OF OSHKOSH No 01060 `' PERMIT — APPLICATION AND RECORD r TYPE:� BLDG ❑ HTG ❑ ELEC �PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - + - - - - - - - - - - - - - - - � - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS ��` Vv � ( � �%/ ` PLAN NO. OWNER � 1(�� C���Yl�u�=''G� _ DESIGNER , USE/NATURE OF WORK �'`' �"1�--� � 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 O Electric Serv. New ❑ Change� Temp ❑ Typ Volt Amps�G—�—� ' 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 /� —� b '—O!� FinaVO.P. �a � 9�G In the performance of this work I agree to perform all work pursuant to rules governing the described construction. �:� � SIGNATURE ��'Z�Z A NER DATE ADDRESS TELEPHONE# PERMIT NO. � ` � O . APPL. DATE � �/v �� ELEC. CONTR. '�"�2�"�'`� �� ''L� O',�NER � D'L-� � � �'� ADDRESS — �'`� � �� �-'' ; NATURE OF WORK �----� q � _ �,-�,c - ,.,Z -�'%-�-F , ELEC. SERV. NEW CHANGE TEMP. � _ � � DESC. TYPE - lo C� , -- �.c/ VOLTS 3° �� AMPS.��� FIX' S ✓ RECEP S CIRC'S APPLIANCES SIGNS � INSP. ROUGHIN� � �' ' SERVICE � '1�'"' FINAL "�b ` EST. COST � o PERMIT FEE � _ ATE PD. -e2 ' 6 REMARKS