HomeMy WebLinkAbout0099798-Electric (dryer outlet)OSHKOSH
ON THE WATER
,Job Address 330 S EAGLE ST
Contractor LARK ELECTRIC
Service [~ New
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner LORI M BOUGIE
Category 612 - Residential-Single Family Addition/Ret
Amps 30
(~) Change (~) Temp
Type I~ Overhead
Circuits 1
Switches 0
No 99798
Create Date 02/12/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Wire dryer outlet.
Work
Fees: Valuation
Issued By:
$250.00
Plan Approval
$0.00 Permit Fee Paid
$20.00
Date 02/12/2003
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
ELECTRICAL PERMIT APPLICATION
All infonmtion after bold categories must be provided.
Incomplete applications will not be processed.
O./HKO./H
ON THF 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 ¥ou want this processed through your account []
DATE 12- o
JOB ADDRESS ~ 3 tD .5", ~",/~7 ~,/_. ~
OWNER
CONTRACTOR
CltECK [] ALL APPLICABLE
USE CATEGORY
171Single Family I-1DuPlex
ElMulti-Family I-qRental
TYPE
SERVICE F1New
[3Change
F1Temporary
[2Not Applicable
FILL IN THE, APPROPRIATE BLANK WITH THE NUMBER
Volts t2~ / z~o Receptacles # /
Phase /
Amps - ~ Switch es #
[3Commercial Ullndustrial
[3Overhead [2Not Applicable
I'-IUnderground
Circuits # !
Fixtures #
CHECK [] ALL APPLICABLE
[2Range [2Dishwasher [3Garbage Disposal
EIFan OR Blower [3Furnace [2A/C
[3Motors [3Gas Pumps [3Other
[]Dryer
[3Electric Sign
DESCRIPTION OF ALL WORK BEING DONE
[2Water Heater
VALUE (Including labor and all materials includ~xtures) $
3/02