HomeMy WebLinkAbout0092516-Electric (service change)
, '1>
.e~,
OSHKOSH
ON THE WATER
Job Address 1217 HARNEY AVE
CITY OF OSHKOSH
No 92516
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner GARY M. / NANCY L. SIMON
Create Date 01/31/2002
Contractor WITZKE ELECTRIC
Service
b New
. Change
o Temp
Category 634 - Residential-Service Change
Type 0 Overhead
Plan
o Underground
Volts
Circuits
3
Fixtures
3
5
Amps
o
Switches
2
Receptacles
Appliances
Use/Nature of SFRf Outside - add receptacles, switches & lights. Upgrade service - move meter.
Work
Fees: Valuation
$2,625.00
Plan Approval
$0.00
Permit Fee Paid
$75.00
Issued By: \-<,'<'1\
Date 02/05/2002
D Permit Voided I
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address
PO BOX 102 155 E PACKER AVE
OSHKOSH
WI 54903 - 102
Telephone Number (920) 235-6572
,....,."'..',""',,i
h'y" ''''',' ,
;'/"~':';)\r:,:_'i::ct, :,; :-:-" " , -', ,,' <;-~i;::r-'\
"I" """""!" ,iele,e,..,
'.~
, ;~~i;\;~~~~'f:~F~~r:~:,~S~:"': 7':'
" osnkc:g!l~iwf"~54903_1l30
Fax"" '(1~'5T'2f6:'50f4"~
PhOne (92'6) 236";50~J,
ELECTRICAL PERMIT APPLICATION
,nolI information after bold categori~s mus: be P!"b~'ided.
Incomplete applications will not be p:::-ocessed.
JOB AD ;)RSSS I;/.I '7 tl. ...{'^- "-1 ~ .....J
O~N::R t0C>..",,-u-r ~: (VtO "\
CONTR.~CTOR WITZKE ELECTRIC INC
!)ATE I ~ 30 ~o ~
CRECK ALL APPLICABLE
USE CATEGORY:
S I NGL E F1<...'11 L YEJ
COMMERC1;'.L[J
Dr;::>; ;;-xD '.I'J';'~l i - =-:l.~"7 T YO
u... - -- .. ...... _ _ ..... ~.J. _.-J _
-NDUS~~ - :'LI- ,
1.." .:.:<..:... U
""~N~"'; 0
:".::" L lr.._
SERVICE:
N:::W ~
CEll.NGE 0
T:::M?OR.~?Y 0
:--iOT
,,-~--,..,,~-~ 0
' -.....!! .to:. -'! ,"
.i";._ _ .o....I_..........~_....
TYPE:
OVERHEAD )SJ
UNDERG?ODND 0
NOT APPLICABLE [J
NUMBER OF FIXTURES ~ SWITCH:::S ~
():~,,7'. '.
-'AMPS ' VOLTS I
?,ECE?TF.CLES -.5
CIECUITS
.3
PHASE
CRECK ALL APPLICABLE
R.l\NGE []
~A'A.'i' ;:c .""' :.; =- .., .,.. =' R 0
r' ..._='- ..._...-.l.-......
r~_::...?3..;G=: :;IS?CS..~..: 0
:E'.!':::?,O
DISHWASHER 0
?AN OR BLOW:::R []
cC?,N.1;e::: []
Ale 0
ELECTRIC SIGN 0
MOTORS 0
GAS ?l:~l?S []
O~,._~
1 :::...:".
DESCRIPTION OF ALL WOR.l:\ BEING DO:NE
~~~~ A~a K~, - S~ ~ ~,,~~~
'-\ty~ 'f'o..~~ ~~,,0~ '-~
~""""'p(eJ.eM~4j
_ v"'t ~ ~ '<. f"l Q... -\. ~.(
".d,,'.\... ~ 0 ~
~m.~;ZC'l'RICrAN ~ .. ~
VALUE (InClUding labor and all materials including light fixtures) ~ "Jrb;)S
..--
T~t Mo:-\-
?5
'i:"~~ynlent with application. Failu.re to ~ay '...-it1':in 30 days '...-ill =esult in
ng doubled or S100.00 plus the nor~al =e=~~t fee, ~hich e,e= lS g.reate=.
OR
if vou want this orocessed through vcur account [J
Electric Permit Work Card
Job Addr@ss 1217 HARNEY AVE Permit Number 92516 Create Date 01/31/2002
~
Owner GARY M. 1 NANCY L. SIMON Contractor WITZKE ELECTRIC
Category 634 - Residential-Service Change
Service b New . ChangeO Temp ON/A I Type o Overhead o Underground o NIA I
Volts Circuits 3 Fixtures 3
Amps 0 Switches 2 Receptacles 5
Fee $75.00 0 Value $2,625.00
Appliances
Use/Nature SFRI Outside - add receptacles, switches & lights. Upgrade service - move meter.
of Work
Inspections:
Date 2/12/02
Type Service
Inspector Jonathan Fischer
U Approved
2/12/02 late am
Date 2/12/02
Type Service
Inspector Jonathan Fischer
2/12/02 called in
2/18/02 mailed in