HomeMy WebLinkAbout0099026-Electric (a/c) SC,:ii; fr
0 CITY OF OSHKOSH No 99026 � y , 6 ` i
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OS ELECTRIC PERMIT - APPLICATION AND RECORD ,Q
ON THE WATER
Job Address 3735 GLENHURST LN Owner JESSICA SMITH Create Date 12/06/2002
Contractor M.R. TEAS INC Category 611 - Residential -New Single Family Wirin Plan
Service 0 New 0 Change 0 Temp Type 0 Overhead 0 Underground
Volts 120/240 Circuits 0 Fixtures 0
Mips 100 Switches 0 Receptacles 0
Appliances A/C
Use /Nature of MOBILE HOME/ Hook -up mobile home & a/c unit.
Work
Fees: Valuation $450.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: Date 12/11/2002
❑ Permit Voided
In the performance of this work 1 agree to perform all work pursuant to rules goveming the described construction.
Signature Date
Agent/Owner
Address 1339 W COLLEGE AVE Appleton WI 54914 - 0 Telephone Number 920 - 830 -2077
City of Oshkosh
Division of Inspection Services (47_ `r
P.O. Box 1130
car:
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084 Of HKOf H
ON THE WATER
ELECTRICAL PERMIT APPLICATION
• All information after bold categories must be provided.
Incomplete applications will not be processed.
• Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection 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 greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds. check here
if you want this processed through your account ❑
JOB ADDRESS 3 7 � 1,�,,� u. v L
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OWNER I d h w I- �( c�2 1 ✓A_ 03, DEC P RTM
CONTRACTOR , c �{ Kic
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DEP MEC
CHECK H ALL APPLICABLE COMMUN DEVEL MEN
SE CATEGORY T
i ngle Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE ViNew ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable ❑Underground hi it 15/- -(
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts MO / 2 Y v Receptacles # Circuits #
Phase / >
Amps / 00 Aut.1, Switches # Fixtures #
•
CHECK ® ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE 64 u k i n.2.0 M /444,4-- 1Q c
VALUE (Including labor and all mate is • ' light fixtures) $ � 62?
MASTER ELECTRICIAN /41r4
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3/02