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OSHKOSH
ON THE WATER
Job Address 211 HIGH AVE
CITY OF OSHKOSH
No 0081173
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner
TIM SCHROEDER (Profiles Hair Studio)
Create Date 09/18/2000
Contractor
VAN ERT ELECTRIC
o Temp
Category 643 - Commercial-Addition/Remodels
Type I. Overhead
Plan
Service
. New
o Change
( ) Underground
Volts
Circuits
Fixtures
Amps
Switches
Receptacles
Appliances Ign
Use/Nature of
Work
Fees: Valuation
Issued By: 5'(Y)S
$375.00
Plan Approval
$0.00
Permit Fee Paid
$20.00
Date 09/18/2000
U Permit VOided I
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Address
1600 BADGER RD
AgenUOwner
KAUKUANA WI 54310 - 0
Telephone Number 715-845-4308
09/14/2000 09:59
19205855115
VAN ERT ELECTRIC COM
Inspection Request & Pennit Application
VAN ERT ELECTRIC OF OSHKOSH
92()"'233-98991 Fax 920-685-3054
Permit application X Work. card Inspection
Todays Date: n I'Jno J;;Z .b
Buildina Address: "S? '.2 ./V. :?l?4_..... :) ~
City 0..:;0/,/.1. {'/, , Town Village
Builder/Owner: P r F) ~.: r /-e.....r 'Ha.r'r 51-(.<d,'C)
Job Number: I-II 9~ E l:f.
Date insoection is needed: Time: Will call: X
OCCUPANCY: Residential: Commercial: Industrial:
Type of inspection: Rough-in: Final: Re-insDeCtion:
,
.,
TemooralV: Change: New: O/H: U/G:
Single phase: Three Phase: Volts: Amperes:
,
I
Service: Rough-in: Final: X Re-i nspection:
~ / 'c _h - d- (1.2 Co ..+-/- ,'., ~ S -,to 4 _~ I i:?n '-.
Q v
I
Called in bv Office: Electrician; Mailed: Fax: ..x
Date & Time:
" ., I
,. .
Permit Fees $ ') n - (!:>o
Valuation $ ~ /.(
CODY to: File: Inspector: PO'Ner Company; Other:
Our contact person for this project is: J ) Q-.tJ. , 'v(. If I"} C<... c.... A eJ' .
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