HomeMy WebLinkAbout0102855-ElectricOSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
3000 POBEREZNY RD
ACTION ELECTRIC
[~ New (~ Change (~ Temp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner E.A.A.
Category 612- Residential-Single Family Addition/Ret
Type I~ Overhead
Circuits 0
Switches 0
No 102855
Create Date 07/15/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of COMM/Temporary wiring for Zaugs Vending.
Work
Fees: Valuation
Issued By:
$5,000.00 Plan Approval
$0.00 Permit Fee Paid
$105.00
Date 07/15/2003
Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address W1906 COUNTY TKJJ KAUKAUNA WI 54130 - 9417 Telephone Number
(920) 788-4020
All in'~orma--lon a~-~.er bold car~egories must be pro ided.
[ncompleue applications will not be processed.
ATE '7 _
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE F,A]~!LY
SERVICE
TYPE OVERHEAD
NO. OF :~X.~,RE~____~_ ....
AMPS .... ~ .......
DUPLEX
CHANGE
UNDERGROUND
~,~TCH~S ~
VOLTS ......... / .........
~' LY RENTAL
,~ULTI-FAMI
TEMPORARY
NOT A!
RECEPTACLES ~__
P}{ASE
COMMERCIAL
CIRCUITS
INDUSTRIAL
CHECK ALL APPLICABLE
DiSHWASBER
ELECTRIC SIGN
BLOWER____
GARBAGE DISPOSAL .... DRYER.___
FU~$ACE A/
MOTORS GAS PUMPS OTHER
DESCRIPTION OF ~L WORK BEING DONE
Submit payment wisk application. Failure to pay wiEhin 30 days will resul~ in
fees being doubled or $100.00 phis the normal permit fee, which ever is
greater.
MASTER ELECTR!CIA/~