HomeMy WebLinkAbout0100173 EOSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
1129W NEW YORKAVE
VAN ERT ELECTRIC
[~ New (~ Change (~ Tamp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner EXCEL PROPERTIES LLC
Category 623- ResidentiaI-DuplexAddition/Remodel
Type I~ Overhead
Circuits 0
Switches 0
No 100173
Create Date 03/12/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of RENTAL/Fix non-compliant code issues. *Job #F1512-DB.
Work
Fees: Valuation
Issued By:
$400.00 Plan Approval
$0.00 Permit Fee Paid
$20.00
Date 03/12/2003
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
03/12/02 11:41 FAX 920 766 0883 VAN ERT ELECTRIC ~001
C. h7 of Oshkosh
Division of l~.specrion S~ices
P.O. Box 1130
Osl~oslL WI 54903ol
Phone (920) 236-5050
Fax (920) 236-~084
ELECTRICAL PERMIT APPLICATION
All information aitcr bold catcgorles must bc provided.
Incomplete applications wtI! not be processed.
· Application(s) arid fee(s) can b~ brought to City Hall Room 205 or mailed to lnsp~tion Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus
normal p~nnii fee, which ever is greater.
OR
(f_You are a contractor participating in the perrr}~Fee Accoftnt System and Aave adequate fund. s,. chec/c /
ff,~u want thisproce,~ed tArou,h your account/~.__ DATE 2~-/0-~
3Oa ADDRESS I I zq ~ __~o.--/~
C][~ECK [] ALL APPLICABLE
USE CATEGORY
[]Single Family
SERVICE ClNew
C1Chsnge
I-IDuplex CIMulti-Family
CITemporary
[~Not Applicable
J~Rental
TYPE
I-'lComrnereial ~Industfial
r'lOverhead l~Not Applicable
I=lUndergrotmd
FILL IN THIr. APPROPRIATE BLANK WITH TI'IR ~ER
VoI~s .' __.1 ] / /~_ Receptacles
"-'/,V/¥
Amps _ _ Switches #
Circuits#
CHI~-CK ~ ALL APPLICABLE
C]Range ~Dishwasher ClOarbage Disposal
C1Fan OR Blower CIFurnace CIA/C
ClMotors OGas Pumps I~Othet
I-IEleclric Sign
r'lWam. Heater
DESCRIPTION OF ALL WORK BEING DONE
"='C".~.~/.~ ~ , __ __
VA.LUE (including labor an~ all materials including light fixtures} $
MASTER ELECTt~CIAN
3/