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HomeMy WebLinkAbout0099521 EOSHKOSH ON THE WATER Job Address Contractor Service Volts 1336 ONTARIO ST TOWN & COUNTRY ELECTRIC [~ New (~ Change (~ Tamp Amps 0 CITY OF OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD Owner CYNTHIA R ERSPAMER Category 612 - Residential-Single Family Addition/Ret Type I~ Overhead Circuits 0 Switches 0 No 99521 Create Date 01/20/2003 Plan ~ Underground Fixtures Receptacles Appliances Use/Nature of SFR/Install 3 overhead lights w/switches in upper bedrooms. Work Fees: Valuation Issued By: $900.00 Plan Approval $0.00 Permit Fee Paid $40.00 Date 01/20/2003 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 2662 AMERICAN DR / PO BOX 627 APPLETON WI 54912 - 627 Telephone Number (920)225-6507 01/20/2003 MON 07:23 FAX 920 738 8987 SERVICE City of Oshkosh Division of Impcction Scrvic.~ P.O. Box 11~0 Os~o~h, WI 54903-1130 P~na (920} 236-5050 F~ (920) 23~50~ ELECTRICAL PERMIT APPLICATION All information after bold categories must bc provided, lncomplele applications will not be processed. ~001/001 * Application(s) and fee(s) c~n be brought to City Hall, Room 205 or mailed lo Inspection Services, PO Box 1128, Oshkosh WI 54903-1128. Commencing work without permit(s) will r~sul! in fees being doubled or $100.00 plus the normal permit fee, which ev~ is greater. OR If you are a contractor~partiei~atine_ in the Permit Fee Account System and have adequate fu.n_ds~check here if you want this processed., through your account [~] CHECK 21 ALL APPLICABLE in CATEGORY gle Family f'lDuplex CIMulti-Family SERVICE [3New rlTemporary ~Changc ~ot Applicable ElReatal I"lCommercial I~Industrial TYPE ElOverhead ~ot Applicable C3Undergrouud FILL IN TBCE APPROPRIATE BLANK WITH THE NUMBER Volts · I Receptacles # Phase Amps Switches # Circuits Fixtures CyrlECK 2I ALL AFPLICABLE ORange ~Dishwnsher 1'3Garbage Disposal ClFan OR Blower OFurnace KIA/C ~Motors I-IGas Pumps J~Dther ~_~Z/'/ DESCRIPTION OF ALL WORK BEING DONE_ ~-v, 6'~ t/ ~Water Hea~c VALUE (Including labor and ill materials ineluding light fixtures)