HomeMy WebLinkAbout0104887-Electric (service change)City 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 1128,
Oshkosh WI 54903-I 128. 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 ./~/~
JOB ADD.SS
CHECK [] ALL APPLICABLE
USE CATEGORY
fingle Family DDuplex [3Multi-Family
SERVICE I-INew [3Temporary
[~hange [3Not Applicable
[2Rental F1Commercial [2Industrial
TYPE ~/.~. ferhead F1Not Applicable
F1Underground
FILL IN THE APPROPRIATE BLANK WITH ~ NUMBER
Volts /~ ~ /..az'~ Receptacles #
Phase
Amps /o o Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
[3Range [3Dishwasher F1Garbage Disposal
[3Fan OR Blower F1Fumace FIA/C
E]Motors [2Gas Pumps [3Other
rnDryer
[3Electric Sign
DESCRIPTION OF ALL WORK BEING DONE
FlWater Heater
VALUE, (Including labor and all materials including light fixtures)
MASTER ELECTRICI~/~/
3/02