HomeMy WebLinkAbout0101987-Electric (service change)OSHKOSH
ON THE WATER
,Job Address 1121 GEORGIA ST
Contractor JACK'S ELECTRIC INC
Service [~ New (~ Change
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner LEO DUCHATSCHEK
Category 634- Residential-Service Change
Amps 100
~ Temp
Type I~ Overhead
Circuits 0
Switches 0
No 101987
Create Date 06/05/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Change service from 60amp to 100amp.
Work
Fees: Valuation
Issued By:
$1,000.00 Plan Approval
$0.00 Permit Fee Paid
$45.00
Date 06/05/2003
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 117 N DOUGLAS ST APPLETON WI 54914 - 0 Telephone Number
(920) 733-1591
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RECEIVED
JUN 0 5 2005
ELECTRICAL' RE R~I'~.~~. ~ TI n i~1
Ali information after%o~ ~e~i~s ~o~~~1
Incomplete applications will not be processed.
O/HKO/H
ON Tt~E 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participatin~ in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account []
JOB ADDRESS
OWNER ~
CONTRACTOR
DATE
CHECK lEI ALL APPLICABLE
USE CATEGORY
Single Family
SERVICE FINew
/~hange
DDuplex IDMulti-Family
E]Temporary
nNot Applicable
[DRental nCommercial Fllndustrial
TYPE j~verhead E]Not Applicable
ElUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts. [~_Or /J 4Zt~ Receptacles #
Phase _ .~.~ ~..._
Amps ?t:~.¢ ~ Switches #
CHECK [] ALL APPLICABLE
F1Range F1Dishwasher F1Garbage Disposal
nFan OR BI ower FlFurnace nA/C
FlMotors 12]Gas Pumps ~3ther
DESCRIPTION OF ALL WORK BEING DONE _.~
VALUE (Including labor and ali materials including light fixtures)..$, 4~.-0-0]
MASTER ELECTRICIAN' ~ ~
3/02