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Home My WebLink About0010269-Electric (service change) .� . E PERMIT NO. ` �� / . APPL. DATE �� `�� ELEC. CONTR. � ' � OWNER �%`t��C��'a� � � ADDRESS l �J� ` u� ^ l �� g NATURE OF WORK � ELEC. SERV. NEW CHANGE TEMP. '� D SC. TYPE — � —�c� VOLTS/1-` 3 �d AMPS �G � FIX' S RECEP 'S IRC'S ; APPLIANCES � --�2_ � 7 � SIGNS _ INSP. ROUGHIN SERVIC -S" i'�$ FIN � EST. COST DO PERMIT FEE �`' DATE PD. - -�� REMARKS � . % , � , 1 � � _ CITY OF OSHKOSH RD N� 10269 PERMIT APPLICATION AND RECO TYPE: BLDG ❑ HTG ❑ ELEC�PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS /v�� • � 1 �" ! , " �— PLAN NO. OWNER �� / � � DESIGNER USE/NATURE OF WORK ��C�-- 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 ELECTR►C CONTRACTOR ��c� �zC � i � �-- Electric Serv. New ❑ Change�Temp ❑ Types� VoItsZZ-�Amps�� f 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 $ • � Permit Fee Paid $ ��-� Park Dedication $ ISSUED BY Date � � �� Final/O.P. � �� In the pertormance of this work I agree to pertorm all work pursuant to rules governing the described construction. SIGNATURE �' v�C AGENT/OWNER DATE ADDRESS TELEPHONE�