HomeMy WebLinkAbout0099361 ECITY OF OSHKOSH
99361
No
OSHKOSHELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job AddressOwnerCreate Date01/08/2003
905 WISCONSIN STLAURA L STANG
ContractorDREXLER ELECTRICCategory623 - Residential-Duplex Addition/RemodelPlan
ServiceTypeOverheadUnderground
NewChangeTemp
VoltsCircuits4Fixtures0
Amps0Switches0Receptacles2
Appliances
Use/Nature of DUPLEX/ Install outlet and make repairs.
Work
Plan Approval$0.00
Fees: Valuation$550.00Permit Fee Paid$25.00
Issued By:Date01/08/2003
Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SignatureDate
Agent/Owner
490 COUNTY ROAD FFPICKETTWI549640589-6700
Address-Telephone Number
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, wi 54903-1130
Fax (920) 236-5084
Phone (920) 236-5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
JOB ADDRESS
CO CTOR
DATE
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY _(DUPLE~ MULTI-FAMILY RENTAL
SERVICE NEW CHANGE TEMPORARY
COMMERCIAL INDUSTRIAL
NOT APPLICABLE
TYPE OVERHEAD UNDERGROUND
NO. OF FIXTURES SWITCHES
NOT APPLICABLE
RECEPTACLES ~ CIRCUITS
AMPS VOLTS / PHASE
CHECK ALL APPLICABLE
RANGE WATER HEATER GARBAGE DISPOSAL DRYER
DISHWASHER FAN OR BLOWER FURNACE A/C
ELECTRIC SIGN MOTORS GAS PUMPS OTHER
DESCRIPTION OF ALL WORK BEING DONE -~----uf-~'7z~'~- ~d/~
Submit payment with application. Failure to pay within 30 days will resul~ in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
MASTER ELECTRICIANVALUE (Including l ab~a.~~_ ll~~ materials including li~~~ ght fixtures)