HomeMy WebLinkAbout0098509-Electric (outlets)
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OSHKOSH
ON THE WATER
Job Address 2015 HARRISON ST
CITY OF OSHKOSH
No 98509
ELECTRIC PERMIT - APPLICATION AND RECORD
Service
18 New
o Change
Owner ROGER M LIND Create Date 11/07/2002
Category 643 - Commercial-Addition/Remodels Plan
o Temp Type o Overhead o Underground
Circuits 2 Fixtures 0
Switches 0 Receptacles 6
Contractor LARK ELECTRIC
Volts 120/20
Amps 0
Appliances
Use/Nature of ~OMM/lnstall outlets.
Work
Fees: Valuation
$700.00
Plan Approval
$0.00
Permit Fee Paid
$30.00
Issued By:
Date 11/07/2002
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
Address 927 N LARK ST PO BOX 3206
Agent/Owner
OSHKOSH
WI 54903 - 3206
Telephone Number 920-231-8625
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RECEIV~KOJH
ON THf WATER
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 APPLlN~m002
All information after bold categories must be provided.
Incomplete applications will not be pr15~TMENT OF
. Application(s) and fee(s) can be brought to City Hall, Room 205~9MM~J'JJ~~~Y~Pf~til 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
Ifvou are a contractor particivating in the Permit Fee Account Svstem and have adequate funds. check here
if vou want this processed throuflh vour account 0
DATE
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JOB ADDRESS
OWNER
CONTRACTOR
.;'(0/5'. linl2P 15 ~AI
'7?oc;~/?.. L/ND
LAR.I<
CHECK 0 ALL APPLICABLE
USE CATEGORY
DSingle Family
DDuplex
DMulti-Family
o Rental
. XCommercial o Industrial
o Overhead DNot Applicable
DUnderground
SERVICE DNew
o Change
o Temporary
DNot Applicable
TYPE
FILL IN THE APPROPRIATE BLANK WITHTHE NUMBER
Volts
Phase
Amps
/2..0 I
I
~
Receptacles #
o
Circuits #
:2-
Switches #
Fixtures #
CHECK ItJ ALL APPLICABLE
ORange
DFan OR Blower
o Motors
DDishwasher
OFumace
DGas Pumps
DGarbage Disposal
DAlC
o Other
o Dryer DWater Heater
DElectric Sign
DESCRIPTION OF ALL WORK BEING DONE
_7;(1' s 7"'l1 L L
~TLL: r/
VALUE (Including labor and all materials includin
MASTER ELECTRICIAN " L
7610 ,
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3/02