HomeMy WebLinkAbout0099059-Electric (service change)OSHKOSH
ON THE WATER
,lob ,Address 352 W 10TH AVE
Contractor LARK ELECTRIC
Service ~ New · Change
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
Amps 100
O Temp
Owner
Category
ROY, ANNE/DONALD SCHMIDT
634 - Residential-Service Change
Type (~ Overhead
Circuits 0
Switches 0
No 99059
Create Date 06/20/2001
Plan
(~ Underground
Fixtures
Receptacles
Appliances
Use/NatUre of SFR/Service change.
Work
Fees: Valuation
Issued By:
$600.00 Plan Approval $0.00 Permit Fee Paid $25.00
Date 12/11/2002
[] 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 Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVED
DEC 1 1 'ZOO?.
DEpAR'I'NIENT OF'
DEVELOPMENT
ELECTRICAL PERMIT APPLICATION
^1] in£orrnation after bold categories must bc 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 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 in the Permit Fee Account System and have adequate funds, check here
if you want thts processed through Four account []
JOB ADDRESS '5 ~'2~
OWNER
CONTRACTOR
CI-W:CK [] ALL APPLICABLE
US~E CATEGORY
[~ingle Family
SERVICE V1New
ElChange
VIDuplex V1Multi-Family
F1Temporary
nNot Applicable
nRental V1Commercial IDIndustrial
TYPE ~'~'verhead V1Not Applicable
nUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts I -z.o / z~,to Receptacles #
phase /
Amps - /oo Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
FlRange ElDishwasher V1Garbage Disposal
IZIFan OR Blower nFumace []AJC
F1Motors nGas Pumps V1Other
[]Dryer
VIElectfic Sign
DESCRIPTION OF ALL WORK BEING DONE
FlWater Heater
VALUE (Including labor and all materials inclulting lil~ht fixtures) $
MASTER ELECTRICIAN (~. ~.]~k ~j
3/02