HomeMy WebLinkAbout0104933-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
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 I 128,
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 ~ou 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 J~/
JOB ADDRESS }") aO ~ 0 ',~
CONTR*CTOR ;c_
CHECK [] ALL APPLICABLE
USE CATEGORY
[]Single Family ~)uplex []Multi-Family
SERVICE ~w E]Temporary
ange F1Not Applicable
IZ1Rental []Commercial []Industrial
TYPE ElOverhead F1Not Applicable
~nderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts /.2_0 / 2. ~0 Receptacles # Circuits #
Phase
Amps 20 o Switches # Fixtures #
CHECK [] ALL APPLICABLE
~ange ElDishwasher [2]Garbage Disposal ~Dryer
FIFan OR Blower '-4~*umace F1A/C F1Electric Sign
F1Motors [] Gas Pumps [] Other
DESCRIPTION OF ALL WORK BEING DONE 6J
~g~WaterHeater
VALUE (Including labor and all materials including light fixtures) $
MASTER ELECTRICIAN ,~o..__~ --
3/02