HomeMy WebLinkAbout0099029 EOSHKOSH
ON THE WATER
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
Job Address 2690 W 20TH AVE Owner
Contractor HERITAGE ELECTRIC INC Category
Service ~ New O Change O Temp
Volts Circuits
Amps 0 Switches
MARK A SEBSTEAD
612 - Residential-Single Family Addition/R
Type O Overhead
0
0
No 99029
Create Date 12/11/2002
Plan
(~) Underground
Fixtures 0
Receptacles 0
Appliances ¥C
Use/Nature of SFPJ Wire new AJC.
Work
Fees: Valuation $145.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By:
Date 12/11/2002
[] 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 720 W WEILAND AVE APPLETON WI 54914 - 0 Telephone Number
(920)734-3734
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-t130
Fax (920) 236-5084
Phone (920) 236~5046
All
JOB ADDRESS
OWNER
CONTRACTOR
CHECK ~ ALL APPLICA. BLE
Incomplete applications will not be processed.
DEC 1 0 20o2
,.20 r,- ~l/' DEPARTMENT OF
S ~ ~7¢~ ~OMMUNiIY DEVELOPMENT
USE CATEGORY
[~ngle Family
[]Duplex []Multi-Family []Rental
DCommerciat
[]Industrial
SERVICE DNew []Temporary
~Change ~ot Applicable
TYPE ~Overhead ~Nou Applicable
~Underground
FILL IN THE APPROPRIATE BLAIN/~ WITH THE NI/MBER
Volts / . Receptacles
Phase '
Amps i Switches #
Circuits
Fixtures
CHECK [] ALL APPLICABLE
[]Range
[]Fan OR Blower
[]Motors
[]Dishwasher
~Furnace
[]Gas Pumps
DGarbage Disposal
~A/C
[]Other
~DRYER []WaTer Heater
[]Electric Sign
DESCRIPTION OF ALL WORK BEING DONE ~ \~ _~ ~ /{_
~. Application(s) and fee(s} can be brought no City Hall, Room 205 or mailed to
Inspecnion Services, PO Box 1128, Oshkosh WI 54903-1128. Commencing work
without permit(s) will result in fees being doubled or $100.00 plus the normal
permit fee, which ever is greener. . -
OR
Check here if you ~anu this processed throuqh your accoun~ []
VALUE (Including labor and all materials including light fixtures) $ /~( ~