HomeMy WebLinkAbout0095977-Electric (service change) 0 CITY OF OSHKOSH No95977
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 418 WAUGOO AVE Owner DONALD F SURRELL Create Date 07/18/2002
Contractor SECKAR ELECTRIC Category 612 - Residential - Single Family Addition /R Plan
Service 0 New • Change O Temp Type 0 Overhead 0 Underground
Volts 120/240 Circuits 0 Fixtures 0
Mips 100 Switches 0 Receptacles 0
Appliances
Use /Nature of SFR/ Service change entrance cable and meter socket. Install grounding.
Work
Fees: Valuation $500.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: KVVN. Date 07/18/2002
❑ 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 5920 COURTNEY PLUMMER RD WINNECONNE WI 54986 - 0 Telephone Number (920) 582 -4909
FROM : SECKAR ELECTRI C FAX NO. . 9202313950 Jul. 17 2002 04: 40PM P1
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084 ',V L!
WATER
M I �
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 5100.00 plus the
normal permit fee, which ever is greater.
OR
1f you are a contractor participating in the Perin F e Account Syst In and have adequate funds. check here
if You want this processjp'JJtmuth Your account
(� Q� DATEJ)C-q 17, loo Z,
JOB ADDRESS I ( [) kW )Goo f U 6"
OWNER 6 eEG 601q, RE LL
CONTRACTOR SE i 6z -a e r C.
CHECK E ALL APPLICABLE
g m CATEGORY
gle Family °Duplex °Multi- Family °Rental °Commercial Dbndustrial
SERVICE °New OTemporary TYPE erhead ONot Applicable
°Change ONot Applicable D nderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER 1 Volts • 1 ZD / 2-4 b Receptacles # Circuits #
Phase
Amps to a Switches # Fixtures #
CHECK ® ALL APPLICABLE
DRange ODishwasher °Garbage Disposal °Dryer °Water Heater
OFan OR Blower °Furnace DA/C °Electric Sign
°Motors °Gas Pumps DOthher l
D S RIPTION OF ALL WORK BEING DONE LE 66' &W Illlr .FAtitAild ce cf t cc
VALUE (Including labor and all mat als iaclodi llgbt xtures) S SOO.
MASTER ELECTRICIAN ,a— ti. L ek '
3/02