HomeMy WebLinkAbout0099193-Electric (fixtures)OSHKOSH
ON THE WATER
Job Address 223 E PARKWAY AVE Owner
Contractor LARK ELECTRIC Category
Service ~) New O Change O Temp I
Volts 120/240 Circuits
Amps 30 Switches
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
JOSEPH S L SCOPACASA/JOSEPHINE
612 - Residential-Single Family Addition/R
Type (~ Overhead
2
0
No 99193
Create Date 12/26/2002
Plan
(~) Underground
Fixtures
Receptacles
Appliances Range & Dryer
Use/Nature of SFPJ Wiring for dryer & range.
Work
Fees: Valuation $450.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By:
Date 12/26/2002
[] Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature Date
AgentJOwner
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
Oshkgsh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVED
DEC 2 o 2002
DEPARTMENT OF
COMMUNITY DEVELOPMENT
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON 'fH[~ 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
i£ you want this processed through your account []
DATE /el ~£~ o2_
JOB ADDRESS
OWNER
CONTRACTOR
CHECK [] ALL APPLICABLE
USE CATEGORY
[EISingle Family I-IDuplex
[2Multi-Family F1Rental
TYPE
SERVICE F1New
DChange
I-1Temporary
FlNot Applicable
l-lCommercial [3Industrial
F1Overhead F1Not Applicable
F1Underground
FILL IN TItE APPROPRIATE BLANK WITH THE NUMBER
Volts ~ ~- o / ~o Receptacles # ~,
Phase /
Amps 3o Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
171Range F1Dishwasher [3Garbage Disposal
FIFan OR Blower DFurnace F1A/C
I-IMotors F1Gas Pumps [] Other
DESCRIPTION OF ALL WORK BEING DONE
[]Dryer
I-1Electric Sign
E]Water Heater
VALUE (Including labor and all materials includ~g light~tures)$
MASTER ELECTRICIAN
3/02