HomeMy WebLinkAbout0093474- Electric (lower area) 0 CITY OF OSHKOSH No 93474
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 820 N LARK ST Owner MR/MRS WILLIS W HAGEN II Create Date 04/08/2002
Contractor LARK ELECTRIC Category 612-Residential-Single Family Addition/R Plan
Service IQ New 0 Change Q Temp I Type Q Overhead Q Underground _
Volts Circuits 0 Fixtures 4
Amps 0 Switches 4 Receptacles 13
Appliances
Use/Nature of SFR/Revise lower area.
Work
Fees: Valuation $600.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: \.<WA Date 04/08/2002
0 Permit Voided 1
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Date
Signature
Agent/Owner
Address 927 N LARK ST PO BOX 3206 OSHKOSH WI 54902 -3347 Telephone Number (920)231-8625
Division of Inspection Services
(;4;) 215 Church Avenue
P.O. Box 1130
(-)(L4 Oshkosh, WI 54903-1130
Fax (920) 236-5084
"'"E Wim' Phone (920) 236-5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed. /�
DATE /�//'e/L 622_
JOB ADDRESS ? Z 0 A/ Xft' K
OWNER it/// 1 l! ; 6' Ei7
CONTRACTOR 24/1
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY DUPLEX MULTI-FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE NEW CHANGE TEMPORARY NOT APPLICABLE
TYPE OVERHEAD UNDERGROUND NOT APPLICABLE
NO. OF FIXTURES 111 SWITCHES ti( RECEPTACLES 1 3 CIRCUITS
AMPS VOLTS / PHASE
CHECK ALL APPLICABLE
RANGE WATER HEATER GARBAGE DISPOSAL DRYER
DISHWASHER
FAN OR BLOWER FURNACE A/C
GAS PUMPS OTHER
MOTORS
ELECTRIC SIGN �/
DESCRIPTION OF ALL WORK BEING DONE �E(�ls =,
� i0f�. /`/ M
• Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100 .00 plus the normal permit fee, which ever is
greater.
411iVALUE (Including labor and all mate,1 . including light fixtures) $ 7:42....e)
JPMASTER ELECTRICIAN 1 -4 P �