HomeMy WebLinkAbout0090082-Electric (service change)I~ CITY OF OSHKOSH Nosooa2
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 833 JOHN AVE Owner 833 JOHN AVENUE LLC Create Date 10/04/2001
Contractor T RUCK ELEC Category 634 -Residential-Service Change Plan
Service New f] Change (~ Temp Type (• Overhead ~ Underground
Volts 120/240 Circuits 1 Fixtures 3
Amps 200 Switches 4 Receptacles 6
Appliances
Use/Nature of
Work
of
Fees: Valuation $3,000.00 Plan Approval $0.00 Permit Fee Paid $75.00
Issued By: ~~ Date 10/04/2001
Permit Voided
In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Address 690 W 3RD AVE
Agent/Owner
OSHKOSH WI 54902 _ 0
Date
Telephone Number (920) 233-7191
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
E Fax (920) 236-5084
N N
WA
Phone (920)
236-5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
JOB A
OWNER
CONTRACTOR ~ ~ ~ , ~, ~~~~_ ~ ~ ~ ,
CIRCLE ALL APPLICABLE
DATE
IISE CATEGORY SINGLE FAMILY PLE MULTI-FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE NEW ~~IAN'G~'J TEMPORARY NOT APPLICABLE
TYPE VE HE UNDERGROUND NOT APPLICABLE
NO. OF FIXTURES_~_ SWITCHES RECEPTACLES ~ CIRCUITS J
AMPS VOLTS 11~ /~ PHASE
CHECK ALL APPLICABLE
RANGE WATER HEATER
DISHWASHER
ELECTRIC SIGN
FAN OR BLOWER
MOTORS
DESCRIPTION OF ALL WORK BEING DONE
GARBAGE DISPOSAL-
- FURNACE_
GAS PUMPS
~~
t
DRYER
A/C
OTHER
• 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.
VALIIE (Including 1 o and all materials including light fixtures) $ ~ app . N
t
MA3TSR SLSCTRICI ~~/~M144 ( / / _, A _ ~ ` S~