HomeMy WebLinkAbout0099919-Electric (outlets)OSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts 120
141 CHURCH AVE
LARK ELECTRIC
[~ New (~ Change (~ Tamp
Amps 20
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner NICKA/LISA M JENSEN
Category 643- Commercial-Addition/Remodels
Type I~ Overhead
Circuits 2
Switches 0
No 99919
Create Date 02/24/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of COMM/Install outlets.
Work
Fees: Valuation
Issued By:
$400.00
Plan Approval
$0.00 Permit Fee Paid
$20.00
Date 02/24/2003
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
Phone (920) 236-5050 r,,~-/ ,' ~OJ¢. ~,^ /~
Fax (920) 236 5084 ~ -~ '~/~,~4~
. . , , ,-
All info~afion after bold categories must be p~.
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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participatin~ in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account []
JOB ADDRESS /~l
OWNER /4fi
CONTRACTOR
CHECK [] ALL APPLICABLE
USE CATEGORY
F1Single Family I-'lDuplex
[] Multi-Family
[]Rental
SERVICE F1New UlTemporary TYPE
E]Change F1Not Applicable
[]commercial Fllndustrial
IZIOverhead IZlNot Applicable
ElUnderground
FILL IN TIlE APPROPRIATE BLANK WITH THE NUMBER
Volts t z e / Receptacles #
Phase /
Amps - Ro Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
UIRange
F1Fan OR Blower
[]Motors
[]Dishwasher
F1Furnace
F1Gas Pumps
F1Garbage Disposal
U]A/C
[]Other
FIDryer
IZlElectric Sign
DESCRIPTION OF ALL WORK BEING DONE
U1Water Heater
VALUE (Including labor and all materials i~ight fixtures)~$
MASTER ELECTRICIAN ~"'~, ~/..~,~_ ~p._~ ' -
3/02