HomeMy WebLinkAbout0091913-Electric (additional work)/~"~ CITY OF OSHKOSH No 91913
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 819 JOHN AVE Owner JEFFREY J WICINSKY Create Date 12/20/2001
Contractor HERITAGE ELECTRIC INC Category 623 -Residential-Duplex Addition/Remode Plan
Service New ~ Change ~ Temp Type ~ Overhead ~ Underground_ ___
Volts 120/240 Circuits Fixtures
Amps 100 Switches Receptacles
Appliances
Use/Nature of ENTAU 12/20/01 FINAL ELECTRICAL WORK (RECPS AND LIGHT FIXTURES)
Work
Fees: Valuation $580.00 Plan Approval $0.00 Permit Fee Paid $25.00
Issued By: Date 12/20/2001
Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature ~~~ ~~ / (,~(,,~yy~„ ~ A ~
Date ~~~~~~~
V r~yenuvwner
Address 720 WEST WETLAND AVE APPLETON WI 54914 - 0 Telephone Number (920) 734-3734
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax (920) 236-5084
HK H Phone (920) 236-5046
ON THE WATER
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
JOB ADDRESS ~ ~ ~l!"~
OWNER
CONTR
CHECK H ALL APPLICABLE
USE CATEGORY
^ Single Family ^Duplex ^Multi-Family L~Rental
DATE /~~~ D/Ol
-31.3 `~
^Commercial ^Industrial
SERVICE ^New ^Temporary TYPE ^Overhead ^Not Applicable
^ Change ^Not Applicable OUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts f2o / 2~1~ Receptacles #
Phase j ~
GPs Zoo Switches #
CHECK ® ALL APPLICABLE
^Range ^Dishwasher ^Garbage Disposal
^Fan OR Blower ^Furnace ^A/C
^Motors ^Gas Pumps ^Ot}:er
Circuits #
Fixtures #
^DRYER ^Water Heater
^Electric Sign
DESCRIPTION OF ALL WORK BEING DONE ~/ti ti ~ Sw,~ o~
• Application(s) and fee(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 fees being doubled or $100.00 plus the normal
permit fee, which ever is greater.
OR
Check here if you want this rocessed through your account
VALUE (Including labor and all materials .including light fixtures) $ ~~(~~ d d
MASTER ELECTRICIAN