HomeMy WebLinkAbout0099427-Electric (service change)OSHKOSH
ON THE WATER
,Job Address 2306 JEFFERSON ST
Contractor LARK ELECTRIC
Service [~ New (~ Change
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner BINA R STARKS
Category 634- Residential-Service Change
Amps 100
~) Temp
Type I~ Overhead
Circuits 0
Switches 0
No 99427
Create Date 01/13/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Change service.
Work
Fees: Valuation
Issued By:
$800.00
Plan Approval
$0.00 Permit Fee Paid
$35.00
Date 01/13/2003
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 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
/ RECEIVE D
DEPARTMENT OF
ELEOTRIOAL P E R~' ~¢~T~ 8~¢~ENT
All in£ormation after bold categories must be provided.
Incomplete applications will not be processed.
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 5490%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 in the Permit Fee .~ccount System and have adequate funds, check here
if you wahl this processed through your account []
JOB ADDRESS
CONTRACTOR
DATE
CHECK [] ALL APPLICABLE
USE CATEGORY
[]Single Family F'lDuplex
I-1Multi-Family
SERVICE FINew
I-qChange
F1Temporary
ElNot Applicable
IZIRental
TYPE
ElCommercial Fllndustrial
ElOverhead
FlUnderground
F'lNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts I z c~ / z- ~ o Receptacles #
Phase
Amps - ./o o Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
E1Range ElDishwasher EIGarbage Disposal
EIFan OR Blower EIFurnace mA/C
ElMotors [3Gas Pumps [3Other
DESCRIPTION OF ALL WORK BEING DONE
ElDryer
FlElectric Sign
FlWater Heater
VALUE (Including labor and all materials ~clu~)light fixtures) $
MASTER ELEcTRIciAN ' ~L ' x'--'~ ~-z~, ~----
3/02