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HomeMy WebLinkAboutElectric (sign) /`'� CITY OF OSHKOSH No9]302 OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 16201622 S KOELLER ST Owner RISKEV BUSINESS LLC Create Date OBi2V2002. Contredor B.Q.ELECTRICSERVICES Ca[egory 643-Commercial-AdditioNRemotlels Plan __ Service ��; New C Ohange Q Temp ���, Type ��� Overheatl _ (� Undergmuntl Vol[s Circui[s 0 Fixtures 0 Amps 0 Switches ___ 0 Recep�aclas _ 0 Appliances I, � UselNatureof OMM/ConnecGngpowerforstoresignatroatl. �� Work I I� Fees: Valua�ion S]5.�0 Plan Approval $0.00 Parmit Fee Paitl $20.00 issuea ay: �''M � oaee osnsizooz � Permit Voitled I� In f�e peRormance of this work I ag�ee[o perform all waB pursuanl to rules goveming ihe tlescnbed construction. Signature Date AgenVOwner Atltlress �930 CONGER CT,PO BO%346 OSHKOSH W I 5M1903 -346 Telephone Number (9za)Z33-9005 • . �� 'u� c��y or osnice:n O Division of Inspection Services � P.O. 6ox 1130 � Oshkosh,WI54903-1 1 3 0 �� / Phane(920)236 5050 - Fax (920)236-5084 � ��� ��HK IH ON THF\4ATER ELECTRICAL PERMIT APPLICATION All infocma[ion afcer bold caregories mus[be pmvided. . Incomplete applicaHons will mt be pmcessed. • Applica[ion(s) and fee(s)can be brough[[o Ciry Hall, Room 205 or mailed to Inspec[ion Services, PO Box 1128, Oshkosh WI 54903-7128. Commencing work without permit(s)will res�lt in fees being doubled or$]00.00 plus the no�mal pertnit fee, which ever is greater. ' OR !(vou are a convncmr Dar['cipatittY ii the Perm '( Fee Account Svsrem and have adequate PonAs check here i(vou want this nrocessed throu2h vaur accaunt ❑ DATE_��[��� , JOBADDRESS I�1�� � � �C�'P ��� � • OWIYER C �rp.S �I���U � /� � �oNT�,�TaR�Eie�1-r��� �� ;\ b�� �� ' ; CHECK �ALL APPLICABLE � / USE — � / - ❑Sir �, 11�Oa ly �Rental IACOmmercia] ❑Industrial / \ SER� ��eo�- -�-� .�- `iSS� �6' TYPE ❑Overhead �NotApplicable �-,J DUnderground � nn/ / e,,�p ��� tt> : r�� l��/ �/�3I� CJ' �^"�'"` � FILL -� � Q t -�� o�.���-.,-. �E IYUMBER ������Q� !�, Volts �� ,-.� uv�Lcrls;� �o `t� N Circui[s# ����—K� � PhaS� i` .��.\\ �' ��b�c . . . Amp� � � - Fiztures# ,,,, /a_� R-e.�,� 9��� ca,uW ��� ,�o t �ssuv re oz- 1�1p�l�,y � CHE� GV�- z l����- - �G,c.�C' �S �f.iJ�i n..ki c�. 'tw+ ORai rbageDisposal �Dryer OWaterHeate�r ��.¢ ❑Fan � OElechic Sign �.�/G:�CPI,t� ❑Motors ❑Gas Pumps Lp(Other - ^� L/ �l?1cf /�il( llF.SCRIPTION OF ALL WORK^B ING DONE E'� � � K Cl' %Y/C�P� p�!,,B�� .p�� VALUE (Including labor aud ail ma erials iocludio Ijgh[tixlures) e ���C✓�""""' i.Ssu-e �'��° i�u� MwSTER ELECTRICIAN� � ' �. — fCm ., ' � �'�"�,��ul°ti 3io�