HomeMy WebLinkAbout0099069-Electric (water heater)OSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
Amps
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
1761-1765 MARICOPA DR
B. Q. ELECTRIC SERVICES
~) New (~ Change C) Temp
Owner
Category
Circuits
Switches
MOKLER PROPERTIES INC
633 - Residential-Multi-Family;Addition/Re
Type (~ Overhead
0
0
No 99069
Create Date 12/10/2002
Plan
(~ Underground
Fixtures
Receptacles
Appliances ¢Vater Heater
Use/Nature of Init 1765 B/RENTAL/Wire new hot water heater.
Work
Fees: Valuation
Issued By: ~.V
$65.00 Plan Approval
$0.00 Permit Fee Paid $20.00
[] Permit Voided
Date 12/13/2002
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 2930 CONGER CT, PO BOX 346 OSHKOSH WI 54903 - 346 Telephone Number
(920) 233-9005
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Osh_k6Sh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON TH~ WATER
Application(s) and fee(s) can be brought to Cit~ Hall, Room 205 or mailed to Inspection Services, PO Box 1128,.
Oghkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $1.00.00 plus the
normal permit fee, which ever is greater.
OR :
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 []
DATE
CHECK I~ ALL APPLICABLE
USE CATEGORY
FlSingle Family [-1Duplex
~.Multi-Family ~Rental
TYPE
SERVICE ElNew F1Temporary
FlChange "[3Not Applicable
F1Commercial Fllndustrial
F1Overhead F1Not Applicable
nUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles #
Phase
Amps Switches #
Circuits #
Fixtures #
CHECK I~ ALL APPLICABLE
V1Range [3Dishwasher
[3Fan OR Blower F1Furnace
F-1Motors FlGas Pumps
E]Garbage Disposal FlDryer
F1A/C F1Eleetric Sign
F1Other
~Water Heater
DESCRIPTION OF ALL WORK BEING DONE i]O;'e, n Q_ ~4) [qf~-~ [X_)~ 4~¢!"'
c.o_l:\ az+ c, aq
VALUE (Including labor and~%7 includ~~s) $ (d9~. ~
~ASTERELECTRICIAN(-M-'~'44''- 1~' ~--/'C~--