HomeMy WebLinkAbout0095858-Electric (service change) 0 CITY OF OSHKOSH No95858
OSHKOSH ELECTRIC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 1222 BOWEN ST Owner MICHAEL R BREFCZYNSKI Create Date 07/15/2002
Contractor J.A.W.S. ELECTRIC Category 634 Residential Service Change Plan
Service 0 New Change 0 Temp Type 0 Overhead 0 Underground
Volts 120 240 Circuits 0 Fixtures 0
Amps 100 Switches 0 Receptacles 0
Appliances
Use /Nature of SFR/100 AMP overhead service upgrade.
Work
Fees: Valuation $700.00 Plan Approval $0.00 Permit Fee Paid $30.00
Issued By: r--- Date 07/15/2002
Permit Voided
In the performance of this work I agree t eall work pursuant to rules governing the described construction.
Signature J A V Date
Agent/Owner
Address PO BOX 141 VAN DYNE WI 54979,- 141 Telephone Number (920) 688 -2477
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084 O.f HKO.JH
ON THE WATER
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO 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 partic patine in the Permit Fee Account System and have adequate funds. check here
if you want this processed through your account
DATE 7 S /O Z_
JOB ADDRESS 121Z )30 wE o S P
OWNER m I IC A
E n R E/= C Z y l 1
CONTRACTOR J -O E CC
CHECK 0 ALL APPLICABLE
USE CATEGORY
Mingle Family ❑Duplex ❑Multi Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE kOverhead ❑Not Applicable
gChange ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts Re, a 4 b Receptacles Circuits
Phase 0
Amps c Switches Fixtures
CHECK ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE
)0c RmP ov \";EAO■ See.11QE uPGRt
wicc )2E u,G6R 6 in 2 7)/ 8) 0'2-
w/L.L iE R�,y rod ►rl PEc .o,) 7 2 :00 P -m
c_
VALUE (Including labor and all materials including light fixtures) 0
MASTER ELECTRICIAN *0 ‘&313
3/02
Electric Permit Work Card
Job Address 1222 BOWEN ST Permit Number 95858 Create Date 07/15/2002
Owner MICHAEL R BREFCZYNSKI Contractor J.A.W.S. ELECTRIC
Category 634 Residential- Service Change
Service 0 New Change 0 Temp 0 N/A Type Overhead 0 Underground 0 N/A
Volts 120 240 Circuits 0 Fixtures 0
Amps 100 Switches 0 Receptacles 0
Fee $30.00 Value $700.00
Appliances
Use/Nature SFR/100 AMP overhead service upgrade.
of Work
Inspections:
Date Type Service Inspector Jon Fischer approved
Counter Request (at time of permit issuance)
7 /18/02approved
7/18/02 called in
7/22/02 mailed in
Date/Time requested: 07/15/2002 01:38 PM Notice Type: Phone Number:
Access:
Ready Date/Time: 07/18/2002 02:00 PM Requested b J.A.W.S. ELECTRIC
Y IC
0 Reinspect Fee 0 Fee Wavied Reinspect Fee Paid