HomeMy WebLinkAbout0098579 EOSHKOSH
ON THE WATER
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Job Address 522 530 N MAIN ST Owner AUTHORITY OSHKOSH HOUSING Create Date 10/28/2002
Contractor ENCOMPASS ELECTRICAL TECHNOLO( Category 643- Commercial-Addition/Remodels Plan
Service I~ New (~) Change (~) Temp Type I~ Overhead ~ Underground
Volts Circuits 2 Fixtures
Switches 0 Receptacles
Amps 0
No 98579
Appliances &/C
Use/Nature of Commercial/530 N Main St-US Cellular/Provide wiring for HVAC unit as follows: (1) air handler in cell space with SKVV jeat & (1) condensing
Work unit on roof with disconnect.
Fees: Valuation
Issued By:
$989.00 Plan Approval $0.00 Permit Fee Paid $0.00
Date 11/12/2002
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
11/11/2002 MON 12:13 FAX 920 738 8987 SERVICE
~001/001
City of Oshkosh
Division of Inspiration Services
P.O. Box 1130
Oshkosh, WI 54903q
Phone (920) 236-S050
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
All reformation after bold categories must b= provided.
Incomplete applications will not be processed.
· Application(s) ~nd fee(s) can be brought to City Hall, R,oom 205 or mailed to hspecfion Services, PO Box 1128,
Oshkosh WI 54~03-1128. Commencing work without permit(s) will result in f~ms b~ing doubled or $100.00 plus
normal pcrrrdt fee, which ever is greater.
OR
If you are a con_tractor oarticip_arinff in the Permit Fee Account S~stem and Rave ndeauate fundz,
,ATE II,/,, /~ ~
Joa n~vm~ss 530,, A/. A~a i~ s b.
I
CHECK [] ALL APPLICABLE
USE CATEGORY
[3Single Family [2Duplex C3Multi-Family
S~.RVICE rlNew ElTemporary
CIGhang~ [~lNot Applicable
ClRental )~/Commercial CIh~ustrial
T16PE CIOverhead ,]g;Not Applic, abl¢
ElUnd~rground
I~LL IN THE APPROPRIATE BLANK WITH TH~. NUMBER
Volts - / Receptacles #
Phase
Amps Switches #,
Circuits #
Fixtures #
CHECK [] ALL API~LICABI.2g
[2Range ElDishwash~ ElGarbage Disposal ElDryer ElWatcr Heater
ElFan OR. Blower E}Furnace ~{~d~ Olilectric Sign
[3Motors EIGas Pumps rqOther .
D~SCRI~TION OF ALL WORK BEING DOI~ , ~l,~Via( .~/'FT~ -~r" ~VA'~
--(0 ¢?a~_o~s'~.F ,u~,'~- ~ ~ood- wi~s, d.:<~o.,-~ec.~,
VALUE (Including ]shot nnd :ill m~,eriols jo¢luding light fixtares) $ , {~ ~ q. O0