HomeMy WebLinkAbout2002-Electric (storm damage)OSHKOSH
ON THE WATER
Job Address 1422 RUSH AVE Owner
Contractor LARK ELECTRIC Category
Service D New · Change (~ Temp t
Volts 120/240 Circuits
Amps 100 Switches
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
ARLYN A WEBER
634 - Residential-Service Change
Type (~ Overhead
0
0
No 99060
Create Date 07/24/2001
Plan
O Underground
Fixtures
Receptacles
0
Appliances
Use/Nature of SFR/Service change - STORM DAMAGE.
Work
Fees: Valuation
Issued By:
$500.00 Plan Approval $0.00 Permit Fee Paid $20.00
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
RECE[VED
DEC 1 1 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 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
(f you want this processed throug(h your account []
DATE c~ p~:< ~7__
JOB ADDRESS ,/~ Z~T._ ~'~J~
OWNER t,~/~ t~ E~q~
CONTRACTOR /'#aK ~ .
CI-IECK [] ALL APPLICABLE
USE CATEGORY
[Efgingle Family r-lDUplex
FIMulti-Family F-IRental UICommercial []Industrial
SERVICE F1New
~Change
F1Temporary
F1Not Applicable
TYPE [ROverhead
F1Underground
IZlNot Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts i'zo / z.q,,~ Receptacles # Circuits #
Phase /
Amps - /oo Switches # Fixtures #
CHECK [] ALL APPLICABLE
I-1Range F1Dishwasher F1Garbage Disposal FIDryer
FIFan OR Blower IZIFumace FIA/C F1Electric Sign
FIMotors IZlGas Pumps [] Other
DESCRIPTION OF ALL WORK BEING DONE
DWater Heater
VALUE (Including labor and all materials inclu~ing!,~ht fixtures) $
MASTER ELECTRICIAN (~x~'~"~lx-'~'~"'"
3/02