HomeMy WebLinkAbout0104583-Electric (fixture/smoke detector)City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
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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 []
DATE
CHECK [] ALL APPLICABLE
USE CATEGORY
F1Single Family /~uplex
[]Multi-Family
SERVICE FINew E]Temporary
F1Change I~Not Applicable
F1Rental E]Commercial Fllndustrial
TYPE V1Overhead I"lNot Applicable
ElUnderground
FILL IN THE. APPROPRIATE BLANK WITH THE NUMBER
Volts [ ~_.O / ~ ~C) Receptacles # Circuits #
Phase
Amps Switches # / Fixtures # /
CHECK [] ALL APPLICABLE
F1Range F1Dishwasher UlGarbagc Disposal I~Dryer FIWater Heater
F1Fan OR Blower IDFumace E]A/C F1Electric Sign
VIMotors F1Gas Pumps F1Other
DESC~RIPTIQN OF ALL WORK BEING DONE p~f?/~ C~2. f, b/// C~c~ r ~
MASTER ELECTRICIAN
3/02