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Home My WebLink About0017233-Electric (service change) /� CITY OF OSHKOSH N°_ 17233 `' PERM.IT - APPLICATION AND RECORD � TYPE: BLDG ❑ HTG ❑ ELEC� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS �v� "'— �� '� PLAN NO. OWNER 'l J /r��.�'1� i DESIGNER � USE/NATURE OF WORK ` f/ -�O 4� 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. ❑ Chang�Temp ❑ Type��Volts �y 0 Amps� 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 $ aa ��ermit Fee Paid $ S� Park Dedication $ ISSUED BY Date�L "� � — �� Final/O.P. ,,��/ �—�� In the performance of this work I agree to perform all work pursuant to rutes governing the described construction. SIGNATURE 4 �`"" � �, ' � �-1'" '''�''?� '-'�.�i`Gf �-,�c, AGENT/OWNER DATE ADDRESS TELEPHONE# PERMIT NO. ` ��J / . APPL DATE �� -�—�/ ELEC. CONTR. � c • ��-7' OWNER ADDRESS �� – � � � � NATURE OF WORK ERV. NEW CHANGE TENIl�• E -- -w VOLTS I� � d A1�S D �' FIX'S SW'S RECEPT C RC'S APPLI CES - � N P. ROU N ER CE - FIN z � E . COST d��'/ PERM T F "� D T P . � �'4 REMARKS - t . �