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Home My WebLink About0035030-Electric (repair service) � �� : N°_ 35030 � _ CITY OF OSHKOSH PERMIT APPLICATION AND RECORD TYPE: BIDG ❑ HTG ❑ ELEC � PLBG ❑ SIGN ❑ ZONING F�OOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS � �` r � ��L e� PLAN NO. OWNER ~��/l /� Q``Z'��- 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 e � `-- 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 c /' FEES: Valuation $ `—� Permit Fee Paid $ ` �`— Park Dedication $ ISSUED BY Date„�� Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE � �� /� AGENT/OWNER DATE ADDRESS TELEPHONE# ` "�iRMIT NO.� �� , APPL. D TE � a � - �� ELEC. CONTR. � 2�L� OWNER ADDRESS � -" NATURE OF WORK -- � EC. SERV. NEW CHANGE 'TEP'IP- DESC TYPE 3 - w VOLTS /� Z�U AI"�S � d FIX' S SW' S RECEPT' S CIRC'S APPLIANCES SIGNS INSP. ROUGH N SERVICE FINAL EST COST �d �� PERMIT FEE,/O� DATE PD.` ��5'� REMARKS