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Home My WebLink About0036104-Electric (service change) �3 � /, CITY OF OSHKOSH N°- 36104 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC� PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS � Z T � Ji7��'�'I PLAN NO. OWNER �� /��GL-��e- DESIGNER USE/NATURE OF WORK BUILDING CON7'RAGTOR 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��' 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 $ ��d� �� Permit Fee Paid $ � � �"J �� Park Dedication $ ISSUED BY Date I � Final/O.P. In the performance of this work I agree to perform all wqrk pursuant to rules governing the described construction. �� r = __ SIGNATURE •�,- i",,.�- 1 ''��._.- � AGEN"fV,OWNER DATE 9 ADDRESS TELEPHONE# � . �PERMIT NO. O . APPL. DATE �`� % ELEC. CONTR. � aWNER ADDRESS �-L ` NATURE OF WORK E EC. SERV. NEW CHANGE TEMP- D C. TYPE � � -- �VOLTS av �t AMPS FIX' S S 'S RECEPT' S CIRC'S AP LIANCES SI�GNS INSP. ROUGH N SERVICE - FIN EST. COST t� PERMIT FEE B-�DAT PD. 2 93 REMARKS � ��`� ! ; � � 3� � � � � '�ERMIT NO. O . APPL. DATE � � � � ELEC. CONTR. / OWNER c-Gf' /`��' ADDRESS �2-`f�! �� NATURE OF WORK � ' E?�EC SERV NEW �FI �va;/'°_, 'I'EMP- DESC TYPE i L°/Z'�� /f� AMPS too � FIX' S SW' S RECEPT' S CIRC'S � �pPLIANCES � � -- � SZGNS INSP. ROUGH N SERVICE FINAL � EST COST PERMIT E'EE DATE PD.� z� REMARKS � €