HomeMy WebLinkAbout0087635-Electric (storm damage)
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OSHKOSH
ON THE WATER
Job Address 656 MOUNT VERNON ST
CITY OF OSHKOSH
No 87635
ELECTRIC PERMIT - APPLICATION AND RECORD
. Change
Owner KELLY J BURNETT Create Date 07/17/2001
Category 634 - Residential-Service Change Plan
o Temp Type . Overhead o Underground .---J
Circuits Fixtures
Switches Receptacles
Contractor ARROW ELECTRIC OF OSHKOSH
Service
b New
Volts 120/240
Amps 200
Appliances
Use/Nature of RENTAL SFRlstorm damage, repair socket conduit and conductors
Work
Fees: Valuation
Issued By: ~
$554.20
Plan Approval
$0.00
Permit Fee Paid
$25.00
Date 07/17/2001
D Permit Voided I
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address
POBOX 3960 - 280 E FERNAU AVE
OSHKOSH
WI 54903 - 3960
Telephone Number (920) 426-4252
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ON rt-lE WArEil
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax (920) 236-5084
Phone (920) 236-5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
DATE f/ ;;~ /0 (
JOB ADDRESS C.s;-~ rYlt.~ iI~/';'\u.v 5;1-.
OWNER /t.e-IIJ {3..ll'",vtC. 11-
CONTRACTOR ,4 r/lbW 8 (~(.l";r
CIRCLE ALL APPLICABLE
USE CATEGORY eLE FAM~ DUPLEX
~,VI NEW CHANGE
~~
~iir~:;3:, OVERH,EAD UNDERGROUND
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NO. OF FIXTURES
NULTI -FAMILY ~ COMNERCIAL INDUSTRIAL
.
TENPORARY NOT APPLICABLE
NOT APPLICABLE
RECEPTACLES
CIRCUITS
AMPS~~D ..
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VOLTS /;;'cP i"~';;;"
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PHAS;~) ) <f/'...
,
CHECK ALL APPLICABLE
~~GE WATER HEATER
GARBAGE DISPOSAL
DRYER
DISHWASHER FAN OR BLOWER
FURNACE
AjC_
ELECTRIC SIGN MOTORS
GAS PUNPS
OTHER
DESCRIPTION OF ALL WORK BEING DONE .>h,,""1 h4.......A.J" - ~.....~.- c:.U',Lf Q "P~k..:1-
C-.-.J..... eOI'\. &'../c+ CO r s
e Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater. :tI2"\ ()..)
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VALUE (Including labor and all materials including light fixtures)
MASTER ELECTRICIAN
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