HomeMy WebLinkAbout0100210-Electric (bath remodel)OSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
312-322 BROAD ST
HERITAGE ELECTRIC INC
[~ New (~ Change (~ Tamp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner JEFFREY J/SUE A WlCINSKY
Category 623- ResidentiaI-DuplexAddition/Remodel
Type I~ Overhead
Circuits 0
Switches 0
No 100210
Create Date 03/14/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of DUPLEX/#322/Remodel bathroom.
Work
Fees: Valuation
Issued By:
$250.00
Plan Approval
$0.00 Permit Fee Paid
$20.00
Date 03/14/2003
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 720 W WEILAND 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
Phone (920) 236=5046
RECE VE'D
MAR I 12003
- '~ ~ ~ ~ ' ' - DEPARTMENT OF
E~TRIUAL P~R~/~IT APPL~CATiO~ ...... ~_
information after bold categories must bep=ov~[MuNlI¥D[¥[[0?M[NI
incomplete applications will not be, processed.
DATE 3//0/03
CHECK ~ ALL APPLICA-BLE
USE CATEGORY
~Single Family
SERVICE ~New
~Change
~Duptex ~Multi-Famity
~Temporary
~No5 Applicable
F1Rental i ~Commercial Flindustrial
TYPE [lOverhead [lNot Applicable
[lUndergreund
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles
Phase
Amps '~ Switches #
Circuits
Fixtures
CHECK ~ ALL APPLICABLE
~Range
~Fan OR Blower
~Motors
~Dishwasher
~Furnace
~Gas Pumps
~Garbage Disposal
~A/C
[lOther
~DRYER ~Water Heater
~Electric Sign
DESCRIPTION OF ALL WORK BEING DONE
e 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 ddubled or $!00.00 plus the normal
permit fee, which ever is greater ....
OR
Check here if ~ou ~an~ this ~rocessed throuqh ~our account []
VALUE (Inc!uding Iabor and all materials including light fixtures) $ ~00~