HomeMy WebLinkAbout0100088-Electric (service & pylon sign)City of Oihkosh
Division of Inspection Services
P.O. Box 1130 ':' ..... '
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON THE WATER
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 pour account []
JOB ADDRESS ~9~ ~ ~ -~, '%dx--,
CONTRACTOR , ~[~' '~[ ~
C~CK ~ ~L '~PLIC~LE
USE CATEGORY
~Single Fmily ~Duplex
SERVICE nNew
FlChange
[3Multi-Family IZIRental
r-lTemporary TYPE
f-INot Applicable
DATE
[3 Commercial Fllndusthal
FIOverhead I"]Not Applicable
ElUnderground
FILL IN THE APPROPRIATE BLANK WITH TIlE .NUMBER
Volts / ; ;. Receptacles #
Phase
Amps Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
[2Range [3Dishwasher [3Garbage Disposal
[2Fan OR Blower l-IFurnace I-1A/C
[] Motors [] Gas Pumps [] Other
DESCRIPTION OF ALL' WORK BEING DONE
[2Dryer nWater Heater
l'qElectric Sign
VALUE (Including labor and all matgrials including light fixtures) $
MASTER ELEC