HomeMy WebLinkAbout0099578-Electric (wire fireplace)OSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
2359 ALLERTON DR
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
MY ELECTRIC CORP.
~ New (~) Change (~ Temp
Amps 0
Owner
Category
RICHARD/SUSAN HOPPE
612 - Residential-Single Family Addition/R
Type (~) Overhead
Circuits 0
Switches 0
No 99578
Create Date 01/24/2003
Plan
Q Underground
Fixtures
Receptacles
Appliances Fireplace
Use/Nature of SFRJWire gas fireplace
Work
Fees: Valuation
Issued By~
$500.00 Plan Approval $0.00 Permit Fee Paid $20.00
Date 01/24/2003
[] Permit Voided j
In the performance .thLs work I agr¢~ tg~erform all work pp//~uant to rules
~.., ~ ~. governing the described construction.
Signature /" ,.~.../,/~= ~_J~"7',~. ,~.~.~'~Z~~ Date
--'C'/ - - ~'/' ..... ¢,f Agent/Owner '
Address 1512 RUGBY ST/' ,/' OSHKOSH WI 54902 - 6360 Telephone Number
(920) 231-0707
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, 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.
ON THF WATER
· 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 Four account []
DATE / '--2 ~ '~_.~
CHECK [] ALL APPLICABLE
USE CATEGORY
E~ngle Family [Duplex E]Multi-Family
SERVICE E]New E]Temporary
E]Changc DNot Applicable
[Rental
TYPE
FICommercial []Industrial
FIOverhead FINot Applicable
I'-IUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles #
Phase
Amps Switches #'
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
F1Range FIDishwasher [2]Garbage Disposal
I"lFan OR Blower [=lFumace F1A/C
F1Motors [Gas Pumps F1Other
DESCRIPTION OF ALL WORK BEING DONE
F1Dryer F1Water Heater
F1Electric Sign
VALUE (Including labor and all materials including light fixtures)
/
3/02