HomeMy WebLinkAbout0100276 EOSHKOSH
ON THE WATER
JobAddress 812 MERRITTAVE
Contractor TRUCK ELEC
Service [~ New (~ Change (~ Temp
Volts
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner LONNIE T DARLAND
Category 623- ResidentiaI-DuplexAddition/Remodel
Type I~ Overhead
Circuits 0
Switches 0
No 100276
Create Date 03/19/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of DUPLEX/Relocate circuit breaker from basement to 1st floor.
Work
Fees: Valuation
Issued By:
$700.00 Plan Approval
$0.00 Permit Fee Paid
$30.00
Date 03/19/2003
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 690 W 3 RD AVE OSHKOSH WI 54902 - 0 Telephone Number
(920) 233-7191
Phone (920) 236-5046
ELECTRICAL PERMIT APPLI N
All information after bold categories must b~provided.
Incomplete applications will not be processed.
CIRCLE ALL APPLICABLE // ~, /
/ ' /
FAMILY RENTAL
TEMPORARY
COMMERCIAL INDUSTRIAL
NOT APPLICABLE
TYPE OVERHEAD UNDERGROUND
NOT APPLICABLE
NO. OF FIXTURES SWITCHES RECEPTACLES CIRCUITS
AMPS VOLTS /
PHASE
CHECK ALL APPLICABLE
RANGE
DISHWASHER
ELECTRIC SIGN
WATER HEATER
FAN OR BLOWER
MOTORS
DESCRIPTION OF ALL WORK BEING DONE
GARBAGE DISPOSAL
FURNACE
GAS PUMPS
DRYER
A/C
OTHER
Submit payment with application. Failure to pay within 30 days will resul~ in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
VALUE (Including lab r all materia ' cluding light fixtures)
MASTER ELECTRICIAN L i~'' v
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