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Home My WebLink About0012472-Electric (service change) � � CITY OF OSHKOSH N° 12472 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS PLAN NO. , OWNER �` DESIGNER USE/NATURE OF WORK �� G 6 _ `� Y'1!�(-r� � d ,ft 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. New ❑ Change [� Temp ❑ Type� '�� - Volts�,��Amps_�4�J ?`L� l� �-�'�'1� Fixtures Switches X Receptacles�k Circuits_�u . 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 $ � G p P rmit Fee Paid $ 5 � � ��— Park Dedication $ ISSUED BY Date �� – � ' d / Final/O.P. � �� In the performance of t s k I agree to perform all work pursuant to rules governing the described construction. SIGNATURE � � , � , � AGENT/O NER � �DATE ADDRESS TELEPHONE N � � € �: � PERMIT I�TO. � � . APPL. DATE � '�-z -� � E � ELEC. CONTR. LLZ ��=� � � OWNER �D�?-;� ,-��!;��-s� � ; � ADDRESS �� — � ��C.r�.�-�z� � , NATURE OF WORK '` �'� .�- . � ELEC. SERV. NEW CHANGE TEMP. � DESC. TYPE - � � � -�VOLTS i �-�' ��v ANIPS .�Uv FIX' S SW' S RECEPT' � CIRC'S oC � APPLIANCES L e� E , � � SIGNS - � � INSP. ROUGHIN ` a3� SERVICE - ` �� FINAL � y EST. COST PERMIT FEE DATE PD. - -8 = � REMARKS � ' « � � � � � :