HomeMy WebLinkAboutElectric �/�'+ CITY OF OSHKOSH Nosasao
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3300 MEDALIST DR Owner SMET INVESTMENTS LLC Create Date 11/04/2002
Contrector EXCELLENCE ELECTRIC, INC. Category 653-Industrial-Addition/Remodels Plan
Service New � Change � Temp Type � Overhead Q Underground
Volts Cirwits 0 Pixtures 0
Amps 0 Switches 0 Receptacles 0
Appliances
UselNature of IND/Locker room remodel.
Work
Fees: Valuation $5,000.00 Pian Approval $0.00 Permit Fee Paid $�05.00
Issued By: Date 11/04/2002
� Permit Voided I
In the performance of this work I agree to pertorm all work pursuant to rules governing the described construction.
Signature Date
AgenVOwner
Address 321 E MAIN ST PO BOX 78 LITTLE CHUTE WI 54140 -78 Telephone Number (920)687-2442
.. . - � 3v5�33 �dS�
O Divieion of Znapec[ioa 9ervief6 — .� .,... � �`,, .
� 215 Church Aveaue - !
P.O. Box 1130 '-y `� '' t`'��
� Oehkoeh, WI 54903-1130 '
Fax {920) 236-S0B4 �1 Z � -
Phoae (920) 236-5046 �UL � J I 2'J'.��
�...., ";:ti?'".INii�°'J'" ('4f_'
_._. :^,i`,1 s;l_i+ : lJi
::I'., ....f �r ��i'I l5s' ��r
ELECTRICA�,' I�LRb�T�` AFBLICATION
All information after bold categpries must be provided.
Incomplete applicatione will not be procesaed.
DATS /O/3o �Q'Z—
JOB ADDRSSS .33U0 �EDfJUST p/�/dtr S��JOZ
OWNSR �e L'o./�'/P/ZESSOF2/GE i�DWER S�STE/�'IS
� CONTRACT�R Ex cELLEN�E C LE cT�IC . <�I.�C .
CIRCLB ALL APPLICABLH
IISB CATBGORY SINGLE FAMILY DUPLEX MULTI-FAMILY RRNTAL COI�QYIERCIAL INDUSTRIAL
SSRVICS NEW CHRNG� TEMPORARY NOT APPLICABLE
TYPB OVERHEAD UNDERGROUND NOT APPLICABLE
NO. OF FIXTURES SWITCHES REC$PTACLES CIRCUITS
�AMP3 VQLTS / P8AS8
CHSCK ALL APPLICABLB
RANGE_ WATER HEATER_ GARSA(3E DISPOSAL_ DRYER_
DISHWASHER_ FAN OR BL0WER_ EURNACE_ A/C_
ELECTRIC SIGN_ MOTORS_ GAS PUMPS_ OTH&R
D3SCeZIPTIf5I� ^v9' Q.Li. WC?.IC 38°I3Jf3 L'£!:•'.8 :�O-,^�1!L�:Z �C7pM, 2�!y!O IJt�
• Submit payment with agplication. Failure to- pay within 30 daya will result in
fees being doubled or $fi�00.d0 plua the normal permit fee, which ever is
greater.
VALIIB (iacludiag labor sad �1T m►Gria1• laaludiaQ light fixtur��) $ ,�d00• 00
�
MASTBR BLSCTRICIAN � .