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Home My WebLink About0019821-Electric (service change) � CITY OF OSHKOSH N°_ 19821 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS � PLAN NO. OWNER DESIGNER . USE/NATURE OF WORK - 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 FI FC'TRI(� (�nNTRAC'TOR_�^ ��__� ' Electric Serv. New ❑ Change ��p ❑ Type�_ Volts��o Amps Go Fixtures Switches �"l�eceptacles Circuit ° 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!� � � j� Final/O.P. � �� In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGN UR AGENT/OWNER ATE - ADDRESS TELEPHONE# � = � l �� '_��`/ C/ PERMIT NO. � P . DATE � f � . E C. CONTR. OWNER ADDR' ��- ' � ' ` NA E OF WORK . SERV. NEW CHANGE TE1�• C. E - .� -�v VOLTS z °f o A1�S G t? FIX_S_ SW' S pz RECEPT' oc' CIRC'S� nppT rp.rTCE .GN N P. ROUGH N ERVI CE `� � v F IN -�J� EST COST�',l-M 5 e`a = PERMIT FEE �d-- DATE PD.�-d'- D ' RFMp,RKS -