HomeMy WebLinkAbout2003-Electric (outlets, lithgts)OSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
603 SCHOOL AVE
LARK ELECTRIC
[~ New (~ Change (~ Tamp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner MICHAEL A/TERES GORDLEY
Category 612 - Residential-Single Family Addition/Ret
Type I~ Overhead
Circuits 20
Switches 5
No 101185
Create Date 05/01/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances Range
Use/Nature of SFR/Rid exposed knop & tube wiring. Install outlets & lights.
Work
Fees: Valuation
Issued By:
$700.00 Plan Approval
$0.00 Permit Fee Paid
$30.00
Date 05/01/2003
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 927 N LARK ST PO BOX 3206 OSHKOSH WI 54903 - 3206 Telephone Number
920-231-8625
City of Oshkosh
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 THF 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 ~s greater.
OR
If you are a contractor participatinx in the Permit Fee Account System and have adet
(f ¥ou want this processed through your account []
JOB ADDRESS
OWNER
CONTRACTOR
CHECK [] ALL APPLICABLE
F1Multi-Family I-IRental
TYPE
USE CATEGORY
IPlSingle Family FIDuplex
FITemporary
IZINot Applicable
SERVICE F1New
F1Change
check here
DATE
, %
IZlCommercial F1 ffli~ustrial
FIOverhead I"lNot Applicable
F1Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles
Phase
Amps ' Switches #
Circuits #
Fixtures #
!
CHECK [] ALL APPLICABLE
[]Range ElDishwasher IZIGarbage Disposal
[]Fan OR Blower F1Fumace EIA/C
U1Motors F1Gas Pumps l-3Other
DESCRIPTION OF ALL WORK BEING DONE ~t P ~'X taO~E p
/
F1Dryer FlWater Heater
ElElectric Sign
VALUE (Including labor and all materials including light fixtures) $
MASTER ELECTRICIAN
3102