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HomeMy WebLinkAbout0099411 EOSHKOSH ON THE WATER Job Address Contractor Service Volts 614 E NEW YORKAVE B. Q. ELECTRIC SERVICES [~ New (~ Change (~ Temp Amps 100 CITY OF OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD Owner LUCILLE H MOERI LIFE ESTATE Category 634- Residential-Service Change Type I~ Overhead Circuits 0 Switches 0 No 99411 Create Date 01/09/2003 Plan ~ Underground Fixtures Receptacles Appliances Use/Nature of SFR/Install 100A O.H. service change and install 1 wash machine recp. Work Fees: Valuation Issued By: $984.00 Plan Approval $0.00 Permit Fee Paid $45.00 Date 01/09/2003 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 2930 CONGER CT, PO BOX 346 OSHKOSH WI 54903 - 346 Telephone Number (920) 233-9005 · City of Oshkosh Division of Inspection Services P.O. Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5084 O/HKO/H 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 Cit) 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 $1.00.00 plus the normal permit fee, which ever is greater. OR ~(f you are a contractor participating in the Permit Fee Account System and have adequate funds, check here if you want this processed through your account [] [2Multi-Family [] Temporary ' F1Not Applicable CHECK [] ALL APPLICABLE USE CATEGORY ~Single Family r-IDuplex SERVICE F1New ~Change TYPE ~Overhead ~Not Applicable ~Under~ound FILL IN THE APPROPRIATE BLANK WITH THE NUMBER Volts / Receptacles # J Circuits # Phase Si ~c~['e. Amps ~ O0~ Switches # Fixtures # CHECK [] ALL APPLICABLE nRange [2Dishwasher F1Garbage Disposal [:]Dryer [2Water Heater F1Fan OR Blower [2Furnace [2A/C []Electric Sign r'lMotors [2Gas Pumps mOther DESCRIPTION OF ALL WORKBEING~DONE i00-'A ~_~Jr. ~"q'i(~,~.. ~_~6[hO~-'e.,~ V VALUE (Including labor an~n~rialsff~ng,lj ~ures) $ ~<~{'4-. ~.~ MASTER ELECTRICI a' _.W__.XX '> ...---'"-'X 3/02