HomeMy WebLinkAbout0094505-Electric (8 lights)CITY OF OSHKOSH No sa5o5
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Add
ress 1325 EASTMAN ST Owner UNITED CEREBRAL PALSY WINN INC Create Date 05/20/2002
Contractor WITZKE ELECTRIC Category 633 -Residential-Multi-Family Addition/Re Plan
Service New ^ Change ^ Temp T e Overhead
yp ^ g
Under round
Volts
Circuits p
Fixtures g
Amps 0 Switches p
Receptacles 0
Appliances
Use/Nature of
Work
Fees: Valuation $500.00 Plan Approval $0.00 Permit Fee Paid
$20.00
Issued By: ~~~
^ Permit Voided_j
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Agent/Owner
Address PO BOX 102 155 E PACKER AVE OSHKOSH WI 54903 - 102
new
Date
Date 05/20/2002
Telephone Number (920) 235-6572
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1 1 30
Phone (920) 236-5050
Fax (920)236-5084
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ELECTRICAL PERMIT APPLICATION ON THE ~NATr-R
All information after bold categories must be provided.
Incomplete applications will not be processed.
• Application(s) and fee(s) can be brought to Ciry 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
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1 V011 want this prOC2CCV~ ttirOll~{t LOtlr a0001t71f
JOB ADDRESS ~3a3 ~~gSr~rAN ,sr~~
OWNER CLNI T~ (~~rD~i~P~Y/ aa~ c ~!
CONTRACTOR ~/l~l + ~lP ~ ~ 1PrFvr1C,
CHECK B ALL APPLICABLE
USE CATEGORY
^Single Family ^Duplex Multi-Family
SERVICE ^New ^Temporary
^Change ,Not Applicable
DATE 5 / 7 Qo2
^Rental ^Cornmercial ^Industrial
TYPE ^Overhead ,Not Applicable
^Underground
FILL IN THE APPROPRIATE BLA:tiK WITH THE NLtiIBER
Volts / Receptacles m
Phase
Amps Switches r
CHECK El ALL APPLICABLE
Range Dishwasher ^Garbage Disposal
CIFan OR Blower ^Furnace p,vC
^Motors ^Gas Pumps ^Other
Circuits ~
Fixtures #_
^Dryer ^Water Heater
^Electric Sign
DESCRIPTION OF ALL WORK~BEING DOIV'E ~E~i~GVG >Gxas~i~i~
1 CIS ~(/ ~' n Prr L°,~'.lf ~i4~~~s /,L~ ~,~
VALUE (Includin; labor and all
MASTER ELECTRICIAi~I
fixtures) $ ~~~~ Q~
~o'~U~OD 3/oz