HomeMy WebLinkAbout0098837-Electric (service change)OSHKOSH
ON THE WATER
.lob Address 439 N LARKST
Contractor LARK ELECTRIC
Service [~ New
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner MARION DRIESSEN LIFE ESTATE
Category 634- Residential-Service Change
Amps 100
Change (~) Temp
Type I~ Overhead
Circuits 0
Switches 0
No 98837
Create Date 11/19/2002
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Change service.
Work
Fees: Valuation
Issued By:
$900.00
Plan Approval
$0.00 Permit Fee Paid
$40.00
Date 11/27/2002
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 927 N LARK ST PO BOX 3206 OSHKOSH WI 54903 - 3206 Telephone Number
920-231-8625
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECEWED
NOV I 9 ~jY/L
BEPART~IENT OF
ELECTRICAL PERMIT APPLICATION
AH J~[o~atJoa afte~ bold categories ~Qst be pmvi&d.
]~co~]ete ~HcatJo~s wH] aot be ~mcessed.
O/HKO/H
ON THE WATER
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
I£v. ou are a contractor participating in the Permit Fee Account System and have adequate funds, check here
(£ VOU want this vrocessed through your account []
JOB
OWNER
CONTRACTOR
DATE \ ~ iX3 E) ~ dS> 2---
CHECK [] ALL APPLICABLE
USE CATEGORY
l~Single Family
SERVICE EINew
63Change
l-lDuplex []Multi-Family
F1Temporary
EINot Applicable
nRental
TYPE
[Commercial Fllndustrial
F1Overhead FINot Applicable
nUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts I ~ o / ~ '~o Receptacles #
Phase /
Amps /~ ~ Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
' FIRange
[]Fan OR Blower
F1Motors
FIDishwasher
mFurnace
ElGas Pumps
F1Garbage Disposal
E1A/C
ElOther
FIDryer
F1Electric Sign
DESCRIPTION OF ALL WORK BEING DONE
ElWater Heater
all materials including light fixtures)
VALUE (Including labor and ~
MASTER ELECTRICIAN (~, ~ ~_.~_.~>-.~___~---'~
Z~/oz
3/02