HomeMy WebLinkAbout0100889-Electric (cable)OSHKOSH
ON THE WATER
Job Address 223 DALE AVE
Contractor TRUCK ELEC
Service [~ New O Change (~ Temp
Volts
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner DOUGLAS/HEATHER MARTIN
Category 634- Residential-Service Change
Type I~ Overhead
Circuits 0
Switches 0
No 100889
Create Date 04/21/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Repalce damaged cable with PVC
Work
Fees: Valuation
Issued By:
$500.00
Plan Approval
$0.00 Permit Fee Paid
$20.00
Date 04/21/2003
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
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
Of HKO/H
ON TI-tF ',.VATER
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
!f ¥~u 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 DaeSS Zg3
CHECK [] ALL APPLICABLE
USE CATEGORY
,[~ngle Family []Duplex FIMulti-Family DRental
SERVICE ElNew DTemporary TYPE
~C~ange [-1Not Applicable
[]Commercial [2Industrial
[~]O~rhead F1Not Applicable
[2Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts [~ /~:~.q(O Receptacles #
Phase //~,/O
Amps _ O Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
FIRange [2Dishwasher FIGarbage Disposal
FIFan OR Blower FIFumace IDA/C
[] Motors [] Gas Pump s [] Other
DESCRIPTION OF ALL WORK BEING DONE ~-~_~ '~
[3Dryer
FIElectric Sign
F1Water Heater
VALUE (Including labor and s including li~ ~"'~ 7
MASTER ELECTRIcIAN/ [/ [ / f~' ''1~- M,/ /:
3/02