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Home My WebLink About0003678-Electric (service change) � � _ CITY OF OSHKOSH No _ 03678 PERMIT APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS �� w• S�U 1 � ��, PLAN NO. OWNER � DESIGNER USE/NATURE OF WORK � S�✓'U I��- �O � o�O �� h��'(. ��s�P r��t-: .� ;-l�. �S.�Q��— BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Ciass of Const. Occupancy Permit ' HEATING CONTRACTOR Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR �-�-I�- ��«� v � Electric Serv. New ❑ Change�Temp ❑ Type Volts Amps a�7 , 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 �1/� O FEES: Valuation $ ��v(��•� Permit Fee Paid $ `5 � Park Dedication $ ISSUED BY Date � l l�'� / Final/O.P. -�'��",�,`� In the performance of this work I agree to perform all work pursuant to rules governing the described construction. � SIGNATURE �� . v�� - � ��r � AGENT/OWNER DATE ADDRESS TELEPHONE�