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HomeMy WebLinkAbout2001-Electric (underground service) ~ OSHKOSH ON THE WATER Job Address 676 W 3RD AVE CITY OF OSHKOSH No 91685 ELECTRIC PERMIT. APPLICATION AND RECORD Owner DAVID R HANSEN Create Date 12/06/2001 Plan Contractor TRUCK ELEC Category 641 - Commercial-New Service Service . New Volts 120/240 0 Change 0 Temp Type 0 Overhead . Underground~ Circuits Fixtures Amps ~ Switches Receptacles Appliances Use/Nature of ~TORAGE GARAGE/Install new 200amp underground service. Work Fees: Valuation $700.00 Plan Approval $0.00 Permit Fee Paid $30.00 Issued By: <'VV\ Date 12/06/2001 0 Permit Voided I In the performance of this work I agree to perform all work pursuant to rules governing the described construction. Signature Date AgenUOwner Address 690 W 3 RD AVE OSHKOSH WI 54902 -~ Telephone Number (920) 233-7191 ED Division of Inspection Services 215 Church Avenue P.O. Box 1130 O/ I KOOK Oshkosh, WI 54903 -1130 Fax (920) 236 -5084 ON THE WATER Phone (920) 236 -5046 ELECTRICAL PERMIT APPLICATION All information after bold categories must be provided. Incomplete applications will not be processed. DATE 12/t9/01 JOB ADDRESS LOCO l • Qom. OWNER live. 1 \ CONTRACTOR 7. Ruch 1 1 e i (' CIRCLE ALL APPLICABLE USE CATEGORY SINGLE FAMILY DUPLEX MULTI- FAMILY RENTAL COMMERCIAL INDUSTRIAL SERVICE 411:11 CHANGE TEMPORARY NOT APPLICABLE TYPE OVERHEAD UNDERGROUND NOT APPLICABLE NO. OF FIXTURES SWITCHES RECEPTACLES CIRCUITS AMPS 200 VOLTS 110 /2 PHASE y� CHECK ALL APPLICABLE RANGE WATER HEATER GARBAGE DISPOSAL DRYER DISHWASHER FAN OR BLOWER FURNACE A/C ELECTRIC SIGN MOTORS GAS PUMPS OTHER DESCRIPTION OF ALL WORK BEING DONE VMtall new Zoo v amp i 5:'.r-v ► ce _ ,� '' "� �7 • Submit payment with application. Failure to pay within 30 days will result in fees being doubled or $100.00 plus the normal permit fee, which ever is greater. VALUE (Including lab• d all mater'- = cluding light fixtures) $ 7�b 30, CO MASTER ELECTRICIAN / „ 1 ;� / '1