HomeMy WebLinkAbout0098948-Electric (remove knob&tube)OSHKOSH
ON THE WATER
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Job Address 437 W 9TH AVE Owner
Contractor LARK ELECTRIC Category
Service ~ New O Change O Temp I
Volts 120 Circuits
Am ps 15 Switches
DANIEL R SALZER
612 - Residential-Single Family Addition/R
Type (~) Overhead
2
0
No 98948
Create Date 12/05/2002
Plan
(~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Rid small attic of knob & tube,
Work
Fees: Valuation
Issued By:
$500.00 Plan Approval $0.00 Permit Fee Paid $20.00
Date 12/05/2002
[] Permit Voided
In the performance of this work I agree to perform ail work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
OSHKOSH WI 54903 - 3206 , Telephone Number
Address 927 N LARK ST PO BOX 3206 920-231-8625
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
O/1-KO/H Fax (920) 236-5084
ON THE WATER
Phone (920) 236-5046
EiVED
DEC 0 5
Dr~PAR ~ N~cNT OF
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
JOB ADDRESS
DATE
CONTIL~CTOR ~
CIRCLE ALL APPLICABLE
USE CATEGORY~DUPLEX
MULTI-FAMILY RENTAL COMMERCIAL INDUSTRIAL
TEMPORARY
NOT APPLICABLE
RECEPTACLES
PHASE /
NOT APPLICABLE
CIRCUITS
SERVICE NEW CHANGE
TYPE OVERHEAD UNDERGROUND
NO. OF FIXTURES S~ZTCHES
AMPS /~-- VOLTS [20/
CHECK ALL APPLICABLE
RANGE
DISHWASHER
ELECTRIC SIGN
WATER HEATER
FAN OR BLOWER
MOTORS
DESCRIPTION OF ALL WORK BEING DONE
GARBAGE DISPOSAL
FURNACE
GAS PUMPS
DRYER
OTHER
A/C
· Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
VALUE .....
(Including labor and all m~terials including light fixtures) $ ~r
MASTER ELECTRICIAN .