HomeMy WebLinkAbout0096537-Electric (service change) / CITY OF OSHKOSH No96537
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 972 E SUNNYVIEW RD #36 Owner TROY & WENDY ULRICH Create Date 08/12/2002
Contractor WITZKE ELECTRIC Category 634 - Residential - Service Change Plan
Service 0 New 0 Change 0 Temp Type 0 Overhead 0 Underground
Volts 120/240 Circuits 0 Fixtures 0
Amps 50 Switches 0 Receptacles 0
Appliances
Use /Nature of SFR/ Main breaker inmmeter socket defective - Temp fix. Installed new breaker in rt enclosure.
Work
Fees: Valuation $200.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: ViN Date 08/12/2002
Permit Voided
In the performance of this work I agree to perform all work pursuant to rules goveming the described construction.
Signature Date
Agent/Owner
Address PO BOX 102 155 E PACKER AVE OSHKOSH WI 54903 - 102 Telephone Number 920 - 235 -6572
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130
® .
Phone (920) 236 -5050
Fax (920) 236 -5084 O-IHKOIH
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 participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account 0
DATE O "/ " °d
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JOB ADDRESS / 17 o D S Lk 4\4\ J; ..- '- ?■•o o t � Lo+ ` 3 G.
OWNER Le\k�01 @(J Pie (o, gon'LQ .:k1 t..
CONTRACTOR A 1 + 7- E Iecfr G -- -►1C .
G.o „,,,,,.„A - 7e4 rictii.■
CHECK HALL APPLICABLE a 3 1- 3 a 5
USE CATEGORY
Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead ONot Applicable
OChange ❑Not Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts 1 4 0 / a' 0 Receptacles #
Phase J Circuits #
Amps 5° Switches #
Fixtures #
CHECK H ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal p ODryer OWater Heater
OFan OR Blower ❑Furnace O OElectric Sign
❑Motors
❑Gas Pumps ❑Other
-
DESCRIPTION OF ALL O ' BEING DONE k Ple-:N /
° \c,- J - - ._,2 Ft'x - seksfct.liec)
Min
c k,.., V ALUE (Including labor and all m . incl . y f ixtures) $ e er
MASTER ELECTRICIAN
IP iti'"...6 , a 0
3/02