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Home My WebLink About0021290-Electric (service change) /� CITY OF OSHKOSH N� 21290 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS PLAN NO. � OWNER DESIGNER ` . USE/NATURE OF WORK /f� - �- ' �� `- � - /� BUILDING CON7'RACTOR 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 w - Electric Serv. New ❑ Change� Temp ❑ Type,L"�� VoltsL -� Amps� Fixtures Switches Receptacles�_ Circuits� � PLUMBING CONTRACTOR —BT _WH _Disp _WSoft _CBasin —�av _Sh _DW _DF _San. Sewer —WC _FDr _SP _Ur _Storm Sewer � —Sink _LTub _Eject _SS —Water Other FEES: Valuation $ O �� Gf Permit Fee Paid $ �� "'�� Park Dedication $ ISSUED BY �ate l�e °� 1``�� Final/O.P. �� '"��- �� In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE s - � �� AGENT/OWNER DATE ADDRESS � -S � CL� /� //��y,►� G( � TELEPHONE# C � q PERMIT NO. �� 1� � APPL. DATE � � —/ . ELEC. CONTR. , ��. — OWNER �-a-2 � -��L��-� __ ADDRESS � � �� — � " . c NATURE OF WORK EC. SERV. NEW CHANGE TEP�. DESC. TYPE VOLTS Z�' �- �O AMPS FIX' S ' S RECEPT' CIRC' S - APPLIANCES S I�GNS INSP. ROUGHIN SERVICE ' - '`1� FINALI - �4' EST COST S� PERMIT FEE 3 � DATE PD J�� yG' REMARKS