HomeMy WebLinkAbout0099109-Electric CITY OF OSHKOSH
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2200 BADGER AVE Owner CURWOOD INC
Contractor VAN ERT ELECTRIC Category 643- Commercial-Addition/Remodels
Service ~ New C) Change (~ Temp I Type (~) Overhead
Volts 120/208 Circuits 0
Amps 0 Switches 0
No 99t09
Create Date 12/17/2002
Plan
(~) Underground J
Fixtures
Receptacles
Appliances
Use/Nature of ,?,OMM/Build out of 2nd floor on existing building. New office & open office area. *Job #1534.
Work
Fees: Valuation
Issued By:
$70,000.00 Plan Approval $0.00 Permit Fee Paid
[] Permit Voided
$360.00
Date 12/17/2002
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 2000 PROGRESS WAY KAUKUANA WI 54130 - 0 Telephone Number 920-766-3888
12t16/02
~:05 FAX 920 ?$$ 0883
City of Oshkosh
Division of lmpegtlon Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone. (920) 236-$050
Fax (920) 236-$084
VAN ERT ELECTRIC
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
~002
O, fH(O, fH
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box I 128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus
rv~ii-i~al permit fee, which ever is greater.
OR
If you ar.e. a contractor Farticipatin~ in the Permit Fee ~lccount System. pnd have adequate funds, check h
if~ou waot thi~ pr, o. ce$red through your account ~
CHECK ~ AIL APPLICABLE
USE CATEGORY
r'lSinglc Family ClDuplex
[ZIMulti-Family ORontal
TYPE
SERVICE C]New
EIChange
r-lTcmporary
[~Not Applicable
~]'Commercial Ellndustrial
EIOverhead ~Not Applicable
['IUnderground
FILL IN TitE APPROPRIATE BLANK WITH Tile NUM~
Volts '/2 ~ / ~'C~ oc Receptacles #
Phase' -
Amps Switches #
Circuits #
Fixtures #
CI~.CK ~a ALL APPLICABLE
nRange f-tDishwasher r-lGaxba$c Dispo~! nI~yer I2JWater Heater
ClFan OR Blower ['iFumace OMC l-iEleetric Sign
l'lMotors OGas Pumps DOther
DESCRIPTION OF ALL WORK. BEING I~ONE
(Including labor and all m,terial~ indudlng Ught £Lxtures) $ ~ 7q OOO O 0
0o