HomeMy WebLinkAbout0102073-Electric (circuit breaker)OSHKOSH
ON THE WATER
.lob Address 227 DALE AVE
Contractor TRUCK ELEC
Service [~ New
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner ROBERT/BARBARA SHIRTZ
Category 634- Residential-Service Change
Amps 100
Change ~) Temp
Type I~ Overhead
Circuits 0
Switches 0
No 102073
Create Date 06/10/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Install new main circuit breaker.
Work
Fees: Valuation
Issued By:
$250.00 Plan Approval
$0.00 Permit Fee Paid
$20.00
Date 06/10/2003
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
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON THF YVATER
· 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. []
DATE ~/~ ~"~
CHECK [] ALL APPLICABLE
ingATEGORY
le Family F1Duplex EIMulti-Family
SERVICE l-IN [3Temporary
~ffi~hange FINot Applicable
F1Rental
TYPE
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts t~) _./ ?~t.~ Receptacles #
Phase /~f
Amps r?/t"~9 Switches #
F1Commercial Filndustrial
I-IOverhead [3Not Applicable
[3Underground
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
[3Range [3Dishwasher F1Garbage Disposal
[3Fan OR Blower F1Fumace [] A/C
I-'lMotors [] Gas Pumps [] Other
DESCRIPTION OF ALL WORK BEING DQ-NE
VALUE (Including labor and aff~ma~ttl
MASTER ELECTRICIAN///
/
[3Dryer
[3Electric Sign
[3Water Heater
including~) $
/
3/02