HomeMy WebLinkAbout0098836-Electric VOID VOID VOIDCITY OF OSHKOSH
98836
No
V O I D
OSHKOSHELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job AddressOwnerCreate Date11/19/2002
1534 EVANS STHELEN E OLSON
ContractorLARK ELECTRICCategory634 - Residential-Service ChangePlan
ServiceTypeOverheadUnderground
NewChangeTemp
Volts120/240Circuits0Fixtures0
Amps100Switches0Receptacles0
Appliances
Use/Nature of SFR/ Chnage service.
Work
Plan Approval$0.00
Fees: Valuation$900.00Permit Fee Paid$40.00
Issued By:Date11/27/2002
üüPermit Voided
cancelled
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SignatureDate
Agent/Owner
927 N LARK ST PO BOX 3206OSHKOSHWI549033206920-231-8625
Address-Telephone Number
OSHKOSH
ON THE WATER
.lob Address 1534 EVANS ST
Contractor LARK ELECTRIC
Service [~ New
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner HELEN E OLSON
Category 634- Residential-Service Change
Amps 100
Change (~) Temp
Type I~ Overhead
Circuits 0
Switches 0
No 98836
Create Date 11/19/2002
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Chnage 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 Inspecuon Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVED
NOV 1 ~ 2_0~,:~
DEPgRTA4ENT OF
ELE CT RI C/~OL~ti~~'PF~)~¥10 N
All information after bold categories must be provided.
Incomplete applications will not be processed.
OZHKOfH
ON THF \'VATER
· 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 participating i~ the Permit Fee Account System and have adequate funds, check here
(f you want this vrocessed through your account []
JOB ADDRESS
OWNER
CONTRACTOR
DATE
CHECK [] ALL APPLICABLE
USE CATEGORY
I~Single Family
SERVICE F1New
F1Change
VIDuplex ElMulti-Family
[] Temporary
V1Not Applicable
F1Rental
TYPE
F1Commercial Vllndustrial
F1Overhead ElNot Applicable
VIUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts I ~ ~ / z ~/,~ Receptacles #
Phase /
Amps /~ Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
F1Range []Dishwasher VIGarbage Disposal
FIFan OR Blower []Furnace F1A/C
[:lMotors EIGas Pumps F1Other
DESCRIPTION OF ALL WORK BEING DONE
[]Dryer
F'lElectric Sign
VlWater Heater
VALUE (Including labor and all materials includ~g lig~Sures) $ ~v.q~,,
3/02