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HomeMy WebLinkAbout0099520-Electric (breaker)OSHKOSH ON THE WATER Job Address 712 DOCTORS CT Owner Contractor TOWN & COUNTRY ELECTRIC Category Service ~ New 0 Change 0 Temp I Volts Circuits Amps 0 Switches CITY OF OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD AURORA MEDICAL GROUP INC 643 - Commercial-Addition/Remodels Type (~ Overhead 0 0 No 99520 Create Date 01/20/2003 Plan O Underground Fixtures Receptacles Appliances Use/Nature of 3OMM/New 100amp breaker & rs-route feeder and loads for panel. Work Fees: Valuation $1,700.00 Plan Approval $0.00 Issued By: Permit Fee Paid $60.00 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 AgentJOwner Address 2662 AMERICAN DR / PO BOX 627 APPLETON WI 54912 - 627 Telephone Number (920)225-6507 01/16/2003 THU 11:22 FAX 920 738 8987 SERVICE City of Osldcosh Division of Irap~ction S~rvi~es P.O. Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5084 ~001/001 ELECTRICAL PERMIT APPLICATION All information after bold categories must be lnovided. Incomplete applications will not be processed. O.(. HKO/H Application(s) and tee(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 fccs being doubled or $100.00 plus the normal pcr~it tee, which ever is greater. OR l£vou are a contractor participating in_the Permit Fe.e /ic_co_unt SY~tem and have adeauat, e funds, check here if you want this proces~e~, through _your accoun, t. [] DAn., ~] t~ Io ~ CO~nt~CTOlt 'T'O~ -~ ~u~4+v~ CHR~ IPl ALL AIPPLICABLE USE CATEGORY [3Single Family I--IDuplex I"lMulti-Family SERVICE ElNew C1Chang~ EITemporary Applicable I'lRental [~ommercial Ellndustrial TYPE ElOverhead EINot Applicable ElUnderground FILL IN THE AI~PROPRIATE BLANK WITH THE NUMBER Volts - / Receptacles # l~hase Amps Switches # Circuits Fixtures Cmr. CK ~ ALL APPLICABLE C)Rangc ClDishwasher ElFan OR Blower ElFurna~ EIMotors ~Gas Pumps ElGarbagc Disposal EIA/C ElOther DESCRIPTION OF ALL WORK BEING DONE OI~er iqElcotric Sign l~Water Heater VALUE (Intluding labor and all materials including light fixtures) $ 3/02