HomeMy WebLinkAbout0100235-Electric (misc)OSHKOSH
ON THE WATER
.lob Address 1545 #314 ARBORETUM DR
Contractor LARK ELECTRIC
Service [~ New (~ Change
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner REBECCA A BOUCHER
Category 633- ResidentiaI-Multi-FamilyAddition/Rem
Amps 20
~) Temp
Type I~ Overhead
Circuits 4
Switches 0
No 100235
Create Date 03/17/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances Water Heater
Use/Nature of CONDO/Install outlets, lights and water heater.
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 . ~ /r~~
P.o.~ox ~30 · 74~'~ ~ '~ I
Os~osh, WI 54903-1130 ~ ~ ~~/
Phone (920) 236-5050 ' ' . ~~~ ~,
Fax (920)236-5084. ~ ~~J ~
. ELECTRICAL' PERMIT APP~~ V~? ~
~o~p~t~ ~pp~i~ao~ win ~ot b~ p~o~s~d ~ ~ ;~
. · %Z~
· Application(s) ~d fee(s) can be brought to Ci~ Hall, Room 205 or marled to ~spect~on S~, PO Box 1128,
Oshkosh WI 54903-1128. Co~encing work ~thout pemit(s) will result in fees being doub~d or $100.00 plus the
noma] pe~it fee, which ever is ~eater.
OR
I[Fou are a contractor participating in the Permit Fee Account System and ha~e adequate [unds, check here
i[ yo~ wa~t thix procesxed through your account ~
JOB ADDRESS
OWNER
DATE
CONTRACTOR
CHECK [] ALL APPLICABLE
USE CATEGORY
[2Single Family
SERVICE [3New
F1Change
[21Duplex r-dMulti-Family
ElTemporary
[3Not Applicable
I-1Rental
TYPE
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts /z6 / 2 '3/~> Receptacles #
Phase /
Amps - 20 Switches #
F1Commercial Ellndustrial
r'lOverhead [3Not Applicable
[3Underground
Circuits
Fixtures
CHECK [] ALL APPLICABLE
[3Range [3DishWasher r-IGarbage Disposal [3Dryer
I-1Fan OR Blower EIFumace [3A/C [3Electric .Sign
[qMotors [2]Gas Pumps F1Other
rOWater Heater
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures)
MASTER ELECTRICIAN
3/02