HomeMy WebLinkAbout0102856-Electric (change panel)OSHKOSH
ON THE WATER
Job Address 58 BROAD ST
Contractor SCHNEIDER ELECTRIC SERVICES INC
Service ~) New · Change O Temp
Volts 120/240
Amps 100
CITY OF OSHKOSH No 102856
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner JERRY E/KANDIS CALMES
Category 634 - Residential-Service Change
Type (~ Overhead
Circuits 0 Fixtures
Switches 0 Receptacles
Create Date 07/15/2003
Plan
Underground
Appliances
Use/Nature of SFPJ Changing main breaker pane[.
Work
Fees: Valuation
$800.00 Plan Approval $0.00 Permit Fee Paid $35.00
[] Permit Voided
Date 07/15/2003
In the performance of this work I agree to p(~F(orm ~ work pwsuant to rules governing the described construction.
Signature ~' , ,¢~ Agent/Owner Date ,~ "-/,_~'~ - (2_:?
Address W3141 KORTNEY LN SEYMOUR WI 54165 - 0 Telephone Number 920-833-7645
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, Wt 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O HKO_/H
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participatin~ in the Permi.t Fee Account System and have adequate funds, check here
if you want this processed through your account []
DATE
JOB ADDRESS
CONTRACTOR
CRECK [] ALL APPLICABLE
USE CATEGORY
~Single Family [:]Duplex
FlMulti-Family
SERVICE [INew
,~Change
F1Temporary
FINot Applicable
l~]Rental FlCommercial Dlndustrial
TYPE lffiOverhead I"lNot Applicable
[21Underground
FILL IN THE APPROPRIATE BLANK WITH TilE NUMBER
Volts /.~ ~ / ~ ~/~ Receptacles # Circuits
Phase
Amps
CItECK El ALL APPLICABLE
F1Range F1Dishwasher r'lGarbage Disposal
FIFan OR Blower FlFumace IqA/C
F1Motors I--IGas Pumps DOther
[:]Dryer
F1Electric Sign
FlWater Heater
DESCRIPTION OF ALL WORK BEING DONE ("/f~-~'-- ~ 5
VALUE (Including labor and all materials including light fixtures)
3/02