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Home My WebLink About0018567-Electric (service change) � � CITY OF OSHKOSH N°_ 18567 �' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC LBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - t ADDRESS �fG� �� ./ ��"�- PLAN NO. . OWNER�AC.� � ' �--.°i�� DESIGNER USE/NATURE OF WORK �( � `� � a� BUILDING CON�'RACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit HEATING CONTRACTOR Heat ❑ A/C ❑ Vent ❑ FueUSystem Heat Loss BTU'S FI FC'TRIC' C'nNTRAC'TnR ` Electric Serv. New ❑ Change � Temp ❑ Type �� Volts�� a Amps ' °d �� 1 Fixtures Switches Receptacles 4� 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 . bb � �� FEES: Valuation $ `'�- Permit Fee Paid $ ��"� Park Dedication $ ISSUED BY Date � `ZZ'"�� Final/O.P. ��0 �� In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE .�^�a��A'C �0'2°� �� AGEN /OWNER ATE � ADDRESS TELEPHONE# � � ' PERMIT NO. S� � , APPL. DATE � �� 9D ELEC. CONTR. �' 'C �� OWNER �� j�� ADDRESS ,�� '� � r /"//� �� NATURE OF WORK EC. SERV. NEW CHANGE ��• DE C. TY E � --`c� VOLTS 11 s y0 AMPS !� ° FIX' S SW' S �� RECEPT S � CIRC'S D4 AP LIANCES - SIGNS INSP ROUGHIN � SERVI CE `%�' ��cF'INAL/ - � � EST. COST PERMIT FEE DATE PD .�2- l� REMARKS 9 0 0- �� °- � �