HomeMy WebLinkAbout0099968 EOSHKOSH
ON THE WATER
Job Address 1129W NEW YORKAVE
Contractor VAN ERT ELECTRIC
Service [~ New O Change
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner EXCEL PROPERTIES LLC
Category 634- Residential-Service Change
Amps 100
~ Temp
Type I~ Overhead
Circuits 0
Switches 0
No 99968
Create Date 02/26/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Sevice change. *Job #F1512-DD.
Work
Fees: Valuation
Issued By:
$775.00
Plan Approval
$0.00 Permit Fee Paid
$35.00
Date 02/26/2003
Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 2000 PROGRESS WAY KAUKUANA WI 54130 - 0 Telephone Number
920-766-3888
02/28/02 09:48 FAX 920 768 0883 VAN ERT ELECTRIC ~001
City of Oshkosh
Division of/mpection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
All information after bold categories must bc provided.
Incomplete' applications will not I~ processed.
· Application(s) and fca(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh gq 54903.1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus
normal permit fca, which ever is greater.
OR
/f~o.u are a contractor oarticip, atine in the Pertn~t Fe~ dccgunt SFstem and have adequate funds, check /
fi.you want this procetied tfiroug~~ -
CI:[KCK [~ ALL APPLICABLE
S~E,~R lgE CATEGORY
lc Family ClDuplex FIMulti_Family
VIC~ ~C~ge I-ITcmpotary
CINot Applicable
FILL IN TI:rI~. APPROPRIATE BLANK WITH Tm~. NUMBER
Veils · I'~) / ~ Receptacles
Amps i~ 0 Switch~ g
. IDRental [3Commercial El~dustrial
TYPE C]Overhead VINot Applicable
ClUnderground
Circuits #
Fixtures #
CI~__.CK ~ ALL APPLICABLE
CIRangc ElD/shwasher rlGarbage Disposal
ClFan OR Blower rlFurnace fi.adC
VIMotors CIGas Pumps rlOther ___
DE$CRIPT/ON OF ALL WORK BEING DONE ,
ClDrycr
rlElectri= Sign
DWater Heater
VALUE (lneludlng labor an;! all materials including UglR fixtures) $
11/