HomeMy WebLinkAbout0099483-Electric~ity of 9shkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
P~one (920) 236-5050
F~x (920) 236-5084
ELECTRICAL
All information after bold categories must ~e
Incomplete applications will not be processed.
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ON THF \VATER
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
iFvou want this processed through your account []
CItECK [] ALL APPLICABLE
DATE
USE CATEGORY
[] Single Family
SERVICE F1New
I"lChange
ElDuplex I-IMulti-Family
F1Temporary
,l~rqot Applicable
F1Rental
TYPE
I~ommercial Ellndustrial
EIOverhead ~Not Applicable
[3Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts
Phase
An~ps-
Receptacles # a~
Switches # ~/
Circuits
Fixtures
CI-IECK [] ALL APPLICABLE
I-IRange
ElFan OR Blower
IDMotors
I-1Dishwasher
EIFurnace
F'lGas Pumps
[3Garbage Disposal
[3A/C
I-IOther
DESCRIPTION OF ALL WORK BEING DONE
I-1Dryer [3Water Heater
[3Electric Sign
VALUE (Including labor and all materials including light fixtures) $
3/02