HomeMy WebLinkAbout0106195-Electric (receptacle)CITY OF OSHKOSH
106195
No
OSHKOSHELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job AddressOwnerCreate Date01/27/2004
1300 S KOELLER STSHOPKO STORES INC
ContractorWITZKE ELECTRIC INCCategory643 - Commercial-Addition/RemodelsPlan
ServiceTypeOverheadUnderground
NewChangeTemp
Volts110Circuits1Fixtures0
Amps20Switches0Receptacles1
Appliances
Use/Nature of provide and install one 110 volt receptacle
Work
Plan Approval$0.00
Fees: Valuation$300.00Permit Fee Paid$20.00
Issued By:Date01/27/2004
Permit Voided
Parcel Id #1308500100
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
SignatureDate
Agent/Owner
PO BOX 102OSHKOSHWI54903102920-235-6572
Address-Telephone Number
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
CJ N. 6�4 2 :54PM WITZKE ELECTRIC NO.853 P.4
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903.1130
Phone (920) 236.5050 •
Fax (920) 236 -5084
ON 714e WA
ELECTRICAL PERMIT APPLICATION
All information alter 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 S100.00 plus the
normal permit fee, which ever is greater.
OR
v • • , o tra • • • c , in i Permi .-I cc • u • rem and have adeauate fun& check here
ife wn
vot et rhia proces ed u gh vour aeee unt ►r".
c � DATE l - o e- (
JOB ADDRESS 1 30 @�1��
OWNERS N....tbp —
CONTRACTOR \Ale it z.ke . fri c, _Lr1r. ,
CHICK 0 ALL APPLICABLE
VSE CATEGORY ,►�
DSinale Family °Duplex DMulti- Family ❑ Rerun l orn nercial °Industrial
SERVICE DNew ❑T ary . TYPE O0verhead arOrrpplicable
... °Charge 21St Applicable DUn . :rgrourd
FILL IN THE APPROPRIATE BLANK WITH THE YUM ER •
Volts /10 / Receptacles t: 1 Circuits 0 I
Phase 1
Amps &CI Switches Fixtures =
CHECK 91 ALL APPLICABLE
0Rangc DDishwasher r' �.,,,
�G .. Di.- , s:.[ i _Dr:c~ G'4"a:l He,.
_
OFati OR Blower DFumace 0A
❑Motors OG. Pumps G Elac:r ;c Sim
❑Other
•
DESCRIPTION OF ALL WO • BEING DONE e 0 0 - 'r D.444..1 t
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VALLT (Including labor and all m t4121 includi li fix:ures) S _ 360 '1ASTER ELECTRYCLA - P•1r�r -9'"4 , Ip;N ---., • 4 (r'„c�
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