HomeMy WebLinkAbout0102993-ElectricOSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
3000 POBEREZNY RD
TOWN & COUNTRY ELECTRIC
[~ New (~ Change (~ Tamp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner E.A.A.
Category 643- Commercial-Addition/Remodels
Type I~ Overhead
Circuits 0
Switches 0
No 102993
Create Date 07/21/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of COMM/Convention wiring. *Job #929001-3088.
Work
Fees: Valuation
Issued By:
$2,$00.00 Plan Approval
$0.00 Permit Fee Paid
$75.00
Date 07/22/2003
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 2662 AMERICAN DR / PO BOX 627 APPLETON WI 54912 - 627 Telephone Number
(920)225-6507
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.
07/.1.8/2003 WED 08:07 FAX 920 738 8987 SERVICE ~002/005
City of Oshkosh
DivLn/on of lllspection Services
P.O. Box 1130
Oshkosh, WI 54903-I 130
Pho~ (920)
Fax (~20) 236-~084
ELECTRICAL PERMIT APPLICATION
Ali infonuation after bold categories must be provided.
lncoraplete applications will not be proces~d,
Application(s) and fee(s) can be brought to City Hall, Room 205 or marled to Inspection Services, PO Box I 128,
Oshkosh WI 54903-1128. Commencing work without permit(s) w/Il result i~ fees be/ag doubled or $100.00 plus the
normal pcrmlt fcc, which ~ is greater.
OR
you are a contra_~tor portivipatinp in t~te Permii F/~e Account Sy.vtqm and have adeouate funds. (hack here
if'you want this prate.axed through gear account ~
JOB ADDRESS
OWNER
CONTRACTOR
CHECK I~ ALL APPLICABLE
USE CATEGORY
l"{Single Family I-]Duplex [3Multi-Family
SERVICE C3New E]Tcmporary
{'-IChauge [3Not Applicable
[3Rental )/~Comm~rcial [3lndtrs~al
TYPE [~Overhcad ~ot Applicable
I-{Underground
FILL IN T~g APPROPRIATE BLANK WITH THE NUMBER
Volts . / Receptacles # Circuits #
Phase
Amps $witc.hes # FiXtures #
CHECK ~ ALL APPLICABLE
E]Rang, f'lDishwaahor E]Garbagc Disposal ~Dryer EIWater Heater
E]Fan OR Blower e'lFura,~e r'lA/C E]Electric Sign
[3Motors ElGas Pumps [3Other
DESCRIPTION OF ALL WORK BEING DONE ~f~ld i(-~b 7 ~L/' ~o t.o ~/0; ~0 '1~ ~4-'-- -