HomeMy WebLinkAbout0099953-Electric (office trailer)02/21/02 12:08 FAX 920 766 0883 VAN ERT ELECTRIC ~002
City of Oshkosh.
Division of Inspection
P.O. Box 1t30
Oshkosh, WI 54903-1130
Phone (920) 236-~o~o
ELECTRICAL PERMIT APPLICATION
All information after bold categoriea must be provided.
ln¢omplet~ applications will not be processed.
· Application(s) and fee(s) e~an be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box I 128,
Oshkosh WI 54903-I 128, Commencing work without permit(s) will r~sult in fees being doubled or $100.00 plus'
normal pem~t fee, which ever is greater.
OR
If you.are a contractor t~articivatin& in the Permi~,e¢ /lccount System and hav..~ adequate_funds, check h.
i£Vou Want this process'ed through Four a ¢coun~ ~
CHECK i~l ALL APPLICABLE
USE CATEGORY
r'lSingle Family t"IDuplex
~Multi-Family
SERVICE ClNew
I'~Changc
NTemp°mrY
ot Applicable
r'lRental I"lCommercial ~h~dustrial
TYPE C]Overhead /~ot APPlicable
~Undergrotmd
FILL iN ~ APPROPRIATE BLANK V, TrH THE NUMBER
Volts · I Receptacles #
Phase
Amps Switches #
Circuits #
Fixtures #
CHECK Ri ALL APPLICABLE
l"lRange EIDishwasher ClOarbage Disposal
CIFan OR. Blower EIFumacc 1'3A/C
l-lMotors I-1Oas Pumps I'-lOthcr;
DES~RIPTIO~ OF ALL WORK BEING DONE, '~X~ ~----
ElDryer
EIElcctric Sign
ClWater Heater
VALUE (Ineludlng labor an~1.11 mnterinlm ineluding light
'MASTER ELECTRICIAN I tNN.~ ~._.~OU. O. f~--