HomeMy WebLinkAbout2001-Electric (temp service) n CITY OF OSHKOSH No 994t9
� OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Atltlress 1465 S WASHBURN ST Owne� WARREN D STEINERT ETAL Create Da�e OW27I2001
ConVactor ENCOMPASSELECTRICALTECHNOLO Calegory 650-Intlustrial-TemporaryService Plan
Service � New � Chan9e � Temp Type � Overheatl J Unaergrovntl . �
Votls 720I240 Circui�s 0 Fiztures 0
Amps 100 Switches 0 Recep[acles 0
Appliances '.
Use/Nature ot :TEMPORARY SERVICE INSTALLED BV THE DITCH W FRONT OF THE BUILDING FOR AMERI-TECH E�UIPMENT'Job#34735
Work
Fees: Valuati��__ —�_— ____. .. . . ._ I
on $500.00 Plan Approval $0.00 Permit Fee Paitl $120.00
Issuetl By: KY'n Dale 04/Od/2002
'�_] Perml�Voltletl
In ihe pertormance of Ihis work I agree to pertorm all work pursuant�o mles goveming�he tlescnbed wnsVuction.
SignaNre Oa[e
A9enuOwner
Atltlress 2662 AMERICAN DR I PO BOX 62] _APPLETON WI 54912 -62] Telephone Number (920)22&65W
� - �b� 3��35
J�O Division of InsPec[ion Servicea �
� 215 Church Aveme
P.O. Box 1130
t� Oshkoah. WI 59903-1130
Faz (920) 236-5084
�����w���� phone (920) 236-5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
DATS / r��
soa r,nnasss /�(ps S� �/�,�c1.5�9�1!/l9 -`>f�
o�R I�Uarw� 5�eiae�f
. CONTRACTOR CL7CDL'NN(s��
CIRCLE ALL APPLICABLH
USS CATHGORY SINGLE FAMILY DUPLEX MULTI-FAMILY RENTAL COMMERCIAL INDUSTRIAL
SHRVICS NEW CHANGE TEMPORARY NOT APPLICABLE
TYPH OVERHEAD UNDERGROOND NOT APPLICABLE
NO. OP FIXTURES SWITCHES RECEPTACLES CIRCUITS
AMPS VOLTS / PHASH
CHECK ALL APPLICABL6
RANGE WATER HEATER GARBAGE DISPOSAL_ DRYER_
DISHWASHER FAN OR BLOWER_ FURNACE_ A/C_
ELECTRIC SIGN MOTORS GAS P[1MPS_ OTHER
D6SCRIPTION OF ALL WORK SBING DONB
• Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100 .00 plus the normal permit fee, which ever is
greater.
VALUB (Including labor end all materiala including light fixturae) $ �{� .50(�.n�
t�sxax sssexaxcxner ��1r�aQ� '� �icu�� �. �C�✓Y��� f�e : �o��DD
7G1' FL' V� 61 �CL-�-C. t't�
� ��� •OC) ��Q �� hi'I
� � ao . � o
Electric Permit Work Card
Job Atldress 1665 5 WASHBURN 5T Permil Number 0 Creala Oa[e 0912�2001
Owner WARRENDSTEINERTETAL Conlrado� ENCOMPASSELECTRICAI.TECHNOLO
Gategory 650-Intlustrial-TemporaryService
Service C New (� Change� Temp � N/A Type � OverM1eaO ,� Untlergrountl � N/A _
Volts 120240 Circuits FisWres
Amps 100 Switches Receptacles
� Fea E0.00 � Value E0.40
Appliances �"" �
❑selNaWre I�TEMPORARY SERVICE INSTALLEO BY THE DITCH IN FRONT OF THE BUILDING FOR
of Work �(�MERI-TECH EQUIPMENT �
�
Inspec�ions:
Da[e Bl2]/O1 Type Service Inspector � Appmvetl �
B126101 1225 PM
NEED A.S.A.P. -
CALLEO INTO WPS 826I01, MAILED 827101