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HomeMy WebLinkAbout0047210-Electric (service change) , �P �j f� � CITY OF OSHKOSH N�� 47 2'10 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ' - - - - - - - - - - - - - - - - - - - - - - - - - - - • - - - - - - - - - - - - - - - - - - - • - - - - - - - - - - - - - - - - - - - ADDRESS � J � � ` ���'�%��✓ PLAN NO. . OWNER � DESIGNER USE/NATURE OF WORK 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 ❑ Typ�l� Volts` w 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 $ (Q 0 �• �� Permit Fee Paid $ 1�� ° "' Park Dedication $ ISSUED BY ��✓ Date � � Final/O.P. In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE AGENT/OWNER DATE ADDRESS TELEPHONE M �d ; 3 ., u%`�.�' �lr� PERMIT NO. . APPL. DATE ELEC. CONTR. .��c��,� � OWNER ADDRESS (� -3 L �- - �7-t�i'z�---" NATURE OF WORK ELEC. SERV. NEW i o-� TEI�. DESC. TYPE E7// VOLTS - � � Al�S r'� FIX' S SW'S RECEPT' S CIRC'S APPLIANCES SIGN INSP. ROUGHIN SERVICE / 4�' FINAL EST. COST PERMIT FEE DATE PD. REMARKS