HomeMy WebLinkAbout0100962-ElectricOSHKOSH
ON THE WATER
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
Job Address 545 BOYD ST
COntractor TRUCK ELEC
Service ~) New C) Change (~ Temp
Volts
Amps 0
Owner
Categor~
Circuits
Switches
ORLAN RAHN
612 - Residential-Single Family Addition/R
Type
0
No 100962
Create Date 04/24/2003
Plan
~ Underground
Fixtures 0
Receptacles 0
Appliances
Use/Nature of 4/24/03 bathroom remodle
Work
Fees: Valuation
Issued By:
$600.00 Plan Approval $0.00 Permit Fee Paid $25.00
Date 04/24/2003
[] Permit Voided
In the performance of this work¢1 agre~o,,oerform all work pursuant to rules governing the descr bed construction.
Signature ~" /;;?.'~,/----¢'¢~' ,'~/' ~/¢f/'~ ____ ~ ............................ Date
~* ..... ~/ ~ ~gen~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
O%~hkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
O/HKO/H
ON THF 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 []
JOB ADDR]~SS . ~"~-~" (~ C~>C4~ D ~
DATE
CI:[ECK [] ALL APPLICABLE
TEGORY
Family F1Duplex I~Multi-Family V1Rental
SERVICE VINew [:]Temporary TYPE
VIChange VINot Applicable
V1Commercial VlIndustrial
[2]Overhead V1Not Applicable
F1Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles # ~
Phase ~
Amps Switches # -~
Circuits
Fixtures
CHECK [] ALL APPLICABLE
[~aan ge F1Dishwasher V1Garbage Disposal
OR Blower F1Fumace V1A/C
V1Motors V1Gas Pumps v1Other
DESCRIPTION OF ALL WORK BEING DONE ,, ·
VIDryer
VIElectric Sign
FlWaterHeater
MASTER ELECTRICIAN; [ I
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