HomeMy WebLinkAbout0091787-Electric (misc.) CITY OF OSHKOSH No91787
OSHKOSH ELECTRIC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 1016 WINDSOR ST Owner Create Date 12/12/2001
Contractor ARROW ELECTRIC OF OSHKOSH Category 612 Residential Single Family Addition /R Plan
Service 0 New O Change O Temp Type O Overhead 0 Underground
Volts Circuits 1 Fixtures 1
Amps Switches 1 Receptacles 1
Appliances
Use /Nature of SFR/Move 1 outlet refeed and install wiring for 1 light and switch for patio door.
Work
Fees: Valuation $300.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: 144-'
r- Date 12/12/2001
Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature Date /'1jA/
Agent/Owner
Address P 0 BOX 3960 280 E FERNAU AVE OSHKOSH WI 54903 3960 Telephone Number (920) 426 -4252
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
H Oshkosh, WI 54903 -1130
M
Fax (920) 236 -5084
ON T 1 Phone (920) 236 -5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
DATE
JOB ADDRESS
CONTRACTOR 14.f.,-01.4 6-I e cL
CIRCLE ALL APPLICABLE
USE CATEGORY NGLE FAMILY DUPLEX MULTI FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE NEW CHANGE TEMPORARY APPLI
TYPE OVERHEAD UNDERGROUND -44.41i APPLICABL
NO. OF FIXTURES 1 SWITCHES r RECEPTACLES 1 CIRCUITS l
AMPS /00 VOLTS /790 PHASE /A(
CHECK ALL APPLICABLE
RANGE WATER HEATER GARBAGE DISPOSAL DRYER
DISHWASHER FAN OR BLOWER FURNACE A/C
ELECTRIC SIGN MOTORS GAS PUMPS OTHER
DESCRIPTION OF ALL WORK J( BEING DONE r .4 =.o v,�' a
�✓ce'
O i) v Q� ✓4 Li- 4" 17 e -4e e tk C�-w� �✓t 5 44 W 6i I ✓l L 5 1+1-
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 including light fixtures) 2k90..'"
MASTER ELECTRICIAN //l lie s4 ty