HomeMy WebLinkAbout0087284-Electric (conduit)CITY OF OSHKOSH No 87284
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address. 1848 HAZEL ST
Owner
DANA K VAUGHAN
Create Date 07/0512001
Contractor ARROW ELECTRIC OF OSHKOSH
Category
612 - Residential - Single Family Addition /R
Plan
Service New O Change O Temp
Type Overhead
O Underground
Volts 120/240
Circuits
Fixtures
Amps 100
Switches
Receptacles
Appliances
Use /Nature of
Work
Fees: Valuation $578.25 Plan Approval $0.00 Permit Fee Paid
$25.00
Issued By:
❑ Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Agent/Owner
Address P O BOX 3960 - 280 E FERNAU AVE OSHKOSH WI 54903 - 3960
Date
Date 07/05/2001
Telephone Number (920) 426 -4252
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 61J61t j
JOB ADDRESS I !qq !.g AIA40
OWNER T_")AA..^c� ✓4U�%�
CONTRACTOR
CIRCLE ALL APPLICABLE
USE CATEGORY CSINGLE FAMILY_ - DUPLEX MULTI - FAMILY RENTAL COMMERCIAL INDUSTRIAL
ER �CE� NEW CHANGE TEMPORARY NOT APPLICABLE
TYPE OVE UNDERGROUND NOT APPLICABLE
NO. OF FIXTURES SWITCHES RECEPTACLES CIRCUITS
AMPS VOLTS PRASE
CHECK ALL APPLICABLE
RANGE WATER HEATER GARBAGE DISPOSAL
DISHWASHER FAN OR BLOWER FURNACE
ELECTRIC SIGN
MOTORS GAS PUMPS
DRYER
OTHER
A/C
DESCRIPTION OF ALL WORK BEING DONE 401121
® 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. -4 2_S� 00
VALUE (Including labor and all materials including light fixtures) $ 5 - S.ZS
MASTER ELECTRICIAN
Division of
Inspection_ Services
215 Church
Avenue
P.O. Box 1130
Oshkosh, WI
54903 -1130
fH
ON THE
Fax (920)
236 -5084
WATER
Phone (920)
236 -5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 61J61t j
JOB ADDRESS I !qq !.g AIA40
OWNER T_")AA..^c� ✓4U�%�
CONTRACTOR
CIRCLE ALL APPLICABLE
USE CATEGORY CSINGLE FAMILY_ - DUPLEX MULTI - FAMILY RENTAL COMMERCIAL INDUSTRIAL
ER �CE� NEW CHANGE TEMPORARY NOT APPLICABLE
TYPE OVE UNDERGROUND NOT APPLICABLE
NO. OF FIXTURES SWITCHES RECEPTACLES CIRCUITS
AMPS VOLTS PRASE
CHECK ALL APPLICABLE
RANGE WATER HEATER GARBAGE DISPOSAL
DISHWASHER FAN OR BLOWER FURNACE
ELECTRIC SIGN
MOTORS GAS PUMPS
DRYER
OTHER
A/C
DESCRIPTION OF ALL WORK BEING DONE 401121
® 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. -4 2_S� 00
VALUE (Including labor and all materials including light fixtures) $ 5 - S.ZS
MASTER ELECTRICIAN