HomeMy WebLinkAbout0102688 EOSHKOSH
ON THE WATER
Job Address 1215W NEW YORKAVE
Contractor LARK ELECTRIC
Service [~ New (~ Change
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner THOMAS/BARBARA EDWARDS
Category 634- Residential-Service Change
Amps 100
~) Temp
Type I~ Overhead
Circuits 0
Switches 0
No 102688
Create Date 07/07/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Repair service.
Work
Fees: Valuation
Issued By:
$500.00
Plan Approval
$0.00 Permit Fee Paid
$20.00
Date 07/08/2003
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 927 N LARK ST PO BOX 3206 OSHKOSH WI 54903 - 3206 Telephone Number
920-231-8625
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh. WI 54903-1130
Phone (920) 236-5050
Fax 19201 236-5084
I I_£C TRI AL I I RMIT API /II A'
All information after bold categories must be provided.
Incomplete applications will not be processed.
· Application(s) and fee(s) can be brought to Ci.Vy Hail, 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 $I00.00 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 '7 ~--~' ~
JOB ADDRESS
OWNER
CONTRACTOR
CI-IECK [] ALL APPLICABLE
USE CATEGORY
fi~lSingle Family
SERVICE FINew
F1Duplex DMulti-Family
r-ITemporary
~Change [qNot Applicable
DRental IqCommercial 12Industrial
TYPE J~Dverhead F1Not Applicable
FlUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts I zo / ~¥ ~ Receptacles # Circuits #
Phase
Amps - /oe, Switches # Fixtures #
CH~CK [] ALL APPLICABLE
[qRange F1Dishwasher [qGarbage Disposal
UlFan OR Blower F1Fumace [qA/C
F1Motors F1Gas Pumps [2Other
DESCRIPTION OF ALL WORK BEING DONE ~-/o,~ t~
UlDryer
[2Electric Sign
FlWater Heater
VALUE (Including labor and all materials includingJ~ght fixtures)
MASTER ELECTRICIAN tf~ ~'__
3/02