HomeMy WebLinkAbout0094166-Electric (a/c) i CITY OF OSHKOSH No94166
OSHKOSH ELECTRIC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 2003 WINCHESTER AVE Owner DAVID R ROTHE Create Date 05/08/2002
Contractor DREXLER ELECTRIC Category 612 Residential Single Family Addition /R Plan
Service p New 0 Change 0 Temp Type 0 Overhead 0 Underground
Volts Circuits 0 Fixtures 0
Amps 0 Switches 0 Receptacles 0
Appliances a/c
Use /Nature of SFR/ Wire a/c unit.
Work
Fees: Valuation $120.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: kA Date 05/08/2002
El Permit Voided
In the performance of this work I agree to perform all work pursuant to rules goveming the described construction.
Signature Date
Agent/Owner
Address 490 COUNTY ROAD FF PICKETT WI 54964 0 Telephone Number 589 -6700 213 -0230
Division of Inspection Services
215 Church Avenue
P.O. Sox 1130
Oshkosh, WI 54903 -1130
Fax (920) 236 -5084
N H W
Phone (920) 236 -5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 5
JOB ADDRESS 3-00 L.) IK) C 1-e S
OWNER DA
CONTRACTOR a l a LTX10
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY DUPLEX MULTI- FAMILY RENTAL COMMERCIAL INDUSTRIAL
SERVICE NEW CHANGE TEMPORARY NOT APPLICABLE
TYPE OVERHEAD UNDERGROUND NOT APPLICABLE
NO. OF FIXTURES SWITCHES RECEPTACLES CIRCUITS
AMPS VOLTS PHASE
CHECK ALL APPLICABLE
RANGE WATER HEATER GARBAGE DISPOSAL DRYER
DISHWASHER FAN OR BLOWER FURNACE A/C
ELECTRIC SIGN MOTORS GAS PUMPS OTHER
DESCRIPTION OF ALL WORK BEING DONE t J (2 e 41 -c 4-
Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
VALUE (Including labor and a 1 materials i cluding light fixtures)
MASTER ELECTRICIAN