HomeMy WebLinkAbout0099857-ElectricOSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
Amps
CITY 6F OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
1832 DOEMEL ST
ELECTRICAL EQUIPMENT SERVICE IN(
~) New (~) Change C) Temp
0
Owner
Category
DARRYL/KATHLEEN MEENK
612 - Residential-Single Family Addition/R
Type _(~__ Overhead
Circuits 1
Switches 3
Appliances Fan or Blower
No 99857
Create Date 02/17/2003
Plan
_~ Underground
Fixtures
Receptacles
Use/Nature of
Work
SFR/ Wiring for bathroom remodel. *Jim, Elect Equip Serv, will be bringing in a check ASAP.
Fees: Valuat?
Issued By: ~f
$2,000.00 Plan Approval $0.00 Permit Fee Paid $60.00
[] Permit Voided j
Date 02/17/2003
In the performan~,, of this work I agree to perform,,~ork pursuant to rules governing the described construction.
Signature \.]..~ ,¢~ ~ ( ..... ~ ....
( .,~. Agen~Owner
Address ~ ~8 36TH ROAD BERLIN WI 54923 - 0 Telephone Number
(920) 361-2071
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
OJ'HKO/H
ON TNF \,VATER
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
· 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 this processed through your account []
JOB ADDRESS /if ~,.,~ ~/.'.9 e , ~-/~ 4
/,,,
CONT CTOR
CHECK [] ALL APPLICABLE
DATE
USE CATEGORY
) ~Single Family r'-IDuplex F1Multi-Family
SERVICE F1New [3Temporary
[3Change [3Not Applicable
DRental
TYPE
EICommercial I-Ilndustrial
[3Overhead FINot Applicable
[3Underground
FILL IN THE APPROPRIATE BLANK WITH TRE NUMBER
Volts / Receptacles # ~
Phase
Amps Switches # ~
Circuits
Fixtures
CIqECK [] ALL APPLICABLE
[3Range I-IDishwasher [3Garbage Disposal
~Fan OR Blower [3Furnace I"IA/C
F1Motors U1Gas Pumps F1Other
DESCRIPTION OF ALL WORK BEING DONE
[3Dryer [3Water Heater
[3Electric Sign
VALUE (Including labor and all ma~rials including light fixes) Sr-~2 ~ ~ ~9
3/02