HomeMy WebLinkAbout0100234 EOSHKOSH
ON THE WATER
.lob Address 210 E MURDOCKAVE
Contractor LARK ELECTRIC
Service [~ New (~ Change
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner ARLIN D/PAULA J ROTHE
Category 612 - Residential-Single Family Addition/Ret
Amps 20
~) Temp
Type I~ Overhead
Circuits 4
Switches 2
No 100234
Create Date 03/17/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Outlets and kitchen wiring.
Work
Fees: Valuation
Issued By:
$500.00
Plan Approval
$0.00 Permit Fee Paid
$20.00
Date 03/17/2003
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
P.O. Box 1
Oshkosh, WI 54903-1130 . .
Phone (920) 236-5050
Fax (920)236-5084 ,n ~,~
ELECTRICAL PERMIT APPLIC'~'O~~,~
All information after bold categories must b:ePsieOii~l~. )~'~p,';~'Op Incomplete applications will not be pro .
· . .
· Application(s) and fee(s) can be broUght to City Hall, Room 205 or mailed to Inspection Service~, t~O 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 participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account []
JOB ADDRESS
OWNER
CONTRACTOR
CFIECK [] ALL APPLICABLE
USE CATEGORY
[~Single Family V1Duplex
V1Multi-Family
V1Rental
SERVICE V1New [3Temporary TYPE
FlChange F1Not Applicable
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
[3Commercial [3Industrial
FIOverhead [3Not Applicable
[3Underground
Volts ~'~ o / z ~ro Receptacles # '7 Circuits
Phase /
Amps - 20 Switches # 7__ Fixtures
CHECK [] ALL APPLICABLE
[3Range [3Dishwasher V1Garbage Disposal [3Dryer
ElFan OR Blower [3Furnace VIAJC EIElectric Sign
V1Motors F1Gas Pumps ElOther
[3Water Heater
DESCRIPTION OF ALL WORK BEING DONE
. .
VALUE (Including labor and ali materials including light fixtures)
3~02