HomeMy WebLinkAbout0104580-ElectricCity of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, 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 []
DATE
CItECK [] ALL APPLICABLE
USE CATEGORY
~;qingle Family DDuplex DMulti-Family
SERVICE F1New F1Temporary
F1Changc ~Not Applicable
F1Rental r'lCommercial [3Industrial
TYPE ElOverhead 181Not Applicable
EIUnderground
FILL IN THE APPROPRIATE BLANK WITH TIlE NUMBER
Volts / Receptacles # Circuits #
Phase
Amps Switches # Fixtures #
CHECK [] ALL APPLICABLE
DRange r-lDishwasher F1Garbage Disposal
IDFan OR Blower ~Fumace EIA/C
[=]Motors DGas Pumps E]Other
DESCRIPTION OF ALL WORK BEING OONE ~aa.se 40
VALUE (Including labor and all materials including lighMixtures) $
MASTER ELECTRICIAN % r~xce '-~
~Dryer F1Water Heater
ElElectric Sign
3/02