HomeMy WebLinkAbout0088084-Electric (a/c)/~`~ CITY OF OSHKOSH No asosa
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2430 KINGSTON PL Owner LORRAINE M THOMPSON Create Date 07/27/2001
Contractor ARROW ELECTRIC OF OSHKOSH Category 612 -Residential-Single Family Addition/R Plan
Service New Q Change Q Temp Type ~ Overhead n Underground
Volts Circuits Fixtures
Amps Switches Receptacles
Appliances
Use/Nature of
Work
Fees: Valuation $72.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: ~ Date 08/06/2001
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 P O BOX 3960 - 280 E FERNAU AVE OSHKOSH WI 54903 - 3960
Telephone Number (920) 426-4252
Divisior. of Inspection Services
215 Church Avenue
/~-~(~~ P . O . Box 113 0
'~L!~~,~1! ~ Oshkosh, WI 54 903-113 0
Fax (920) 236-5083
Cti ii+E wnrE2 phone (920) 236-5045
ELECTRICAL PERitiIIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
DATE v /
JOB ADDRESS ~~3~ ~~r~c,S~9,~
OWNER ~ nrr~..n p_ ~H~~~++~010.v
CONTRACTOR ~/~'7t,.! ~~~.~~"iG
CIRCLE ALL APPLICABLE
USF~ CATr^.GOR SINGLE FA:*QI DUPLEX MULTI-FAbIILY RENTAL COh1MERCIAL INDUSTRIAL
SERVICE NEW CHAD]GE ' TE~dPORARY NOT APPLICABLE
TYPE OVERHEP.D UNDEP.GROLTND NOT APPLICABLE
h'O. OF FIXTURES SWITCHES RECEPTACLES CIRCUITS
A_~IPS VOLTS / PHASE
CFECK ALL APPLICABLE
RP.r7GE WATER HEATEP. G_~RBP_GE DISPOSAL DRYER
DISITYv'ASHER FAN OR BLOWER +_ FURNACE A/C~
ELECTRIC SIGN MOTORS GAS PUMPS OTHEP.
DESCRIPTION OF ALL WORK BEING DONF, ~~~~, ~ uT
~ 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.
VALUE (Including labor and all materials ir_cluding light fixtures) $
23ASTER ELECTRICIAN ~ ~~~C@ S~~t,it f j
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