HomeMy WebLinkAbout0100274 EOSHKOSH
ON THE WATER
.lob Address 1208 OSHKOSH AVE
Contractor LARK ELECTRIC
Service [~ New (~ Change
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner TERRY L BEHM
Category 634- Residential-Service Change
Amps 150
~) Temp
Type I~ Overhead
Circuits 0
Switches 0
No 100274
Create Date 03/19/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of DUPLEX/Change service.
Work
Fees: Valuation
Issued By:
$2,000.00
Plan Approval
$0.00 Permit Fee Paid
$60.00
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 927 N LARK ST PO BOX 3206 OSHKOSH WI 54903 - 3206 Telephone Number
920-231-8625
Fax (920) 236-5084
ELECTRICAL PERMIT
All information after bold categories
Incomplete applications will not be'
:ATION
ON THE WATER
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed ' )n 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 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
CHECK [] ALL APPLICABLE
USE CATEGORY
FISingle Family I~tDuplex F1Multi-Family
SERVICE []New ElTemPorary
[]Change F1Not Applicable
[2Rental
TYPE
FICommercial Ellndustrial
Iii'Overhead F1Not Applicable
ClUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts I zo / 2. qc, Receptacles #
Phase /
Amps - /go Switches #
CirCuits #
Fixtures #
CtW~CK [] ALL APPLICABLE
ElRange ElDishwasher F1Garbage Disposal
[3Fan OR Blower FIFumace F1A/C
[3Motors [3Gas Pumps [3Other
F1Dryer FlWater Heater
ElElectric Sign
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $
MASTER ELECTRICIAN
000 '-
3/02