HomeMy WebLinkAbout0097278- Electric (garage) CITY OF OSHKOSH No 97278
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1016 N LARK ST Owner OSHKOSH HOUSING AUTHORITY Create Date 09/12/2002
Contractor WITZKE ELECTRIC Category 612-Residential-Single Family Addition/R Plan
Service Q New 0 Change Q Temp Type 0 Overhead Q Underground
Volts 120 Circuits 1 Fixtures 2
Amps 20 Switches 2 Receptacles 1
Appliances
Use/Nature of SFR/Wire new garage.
Work
Fees: Valuation $450.00 Plan Approval $0.00 Permit Fee Paid $0.00
Issued By: YY1 Date 09/13/2002
❑ Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address PO BOX 102 155 E PACKER AVE OSHKOSH WI 54903 -102 Telephone Number 920-235-6572
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh. WI 54903-1130
4...)11r
Phone(920)236-5050
Fax (920)236-5084 O.IHKOIH
ON THE WATER
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
• 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 S 100.00 plus the
normal permit fee, which ever is greater.
OR
If You are a contractor Darticipatina in the Permit Fee Account System and have adeauate funds. check here
if you want this Drocessed through Your account
DATE Oa
JOB ADDRESS /OI (c,
OWNER
CONTRACTOR WI+�K� bIt&ri _ ►1G .
V
CHECK EI ALL APPLICABLE
USE CATEGORY
.Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
SERVICE ONew ❑Temporary TYPE 0 Overhead tot Applicable
❑Change Tot Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER •
Volts /a O / Receptacles # Circuits #
Phase /
Amps 00 Switches # oZ Fixtures # a
CHECK H ALL APPLICABLE
ORange ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sian
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK,BEING DONE ��/r R. (.,a1•
q S e
VALUE (Including labor and all m t rialincl ng li fixtures) S 4/,j O
—
MASTER ELECTRICI_AN �, �'