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HomeMy WebLinkAbout0100282-Electrical (lab)OSHKOSH ON THE WATER Job Address Contractor Service Volts 1600 HAZEL ST TOWN & COUNTRY ELECTRIC [~ New (~ Change (~ Tamp Amps 0 CITY OF OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD Owner OSH AREA SCHL DIST EMELINE COOK Category 643- Commercial-Addition/Remodels Type I~ Overhead Circuits 0 Switches 0 No 100282 Create Date 03/19/2003 Plan ~ Underground Fixtures Receptacles Appliances Use/Nature of COMM/ Install 6 new circuits in the lab. Install 13 - 120V receptacles in the furniture. Work Fees: Valuation Issued By: $3,$90.00 Plan Approval $0.00 Permit Fee Paid $90.00 Date 03/19/2003 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 2662 AMERICAN DR / PO BOX 627 APPLETON WI 54912 - 627 Telephone Number (920)225-6507 City of Oshkosh Division of Inspection Services P.O. Box 1130 Oshkosh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5084 O/HKO/H ON THE WATER Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Serv/ces, PO Box 1128, Oshkosh WI 5490%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 Jf vou are a contractor participatin~ in the Permit Fee Account System and have adequate funds, check here if you want this processed through your account [] ~OB ADDRESS t[oO0 Hazel CONTRACTOR dlb]a CHECK [] ALL APPLICABLE DATE 3-t7-O3, USE CATEGORY fi]Single Family fi]Duplex [2Multi-Family [2Rental SERVICE []New F1Temporary TYPE []Change I-1Not Applicable ,~Commercial E]Industrial [] Overhead [2Not Applicable FlUnderground FILL IN THE APPROPRIATE BLANK WITH THE NUMBER Volts / ReCeptacles g J ~ Circuits # Phase Amps Switches # Fixtures # CHECK [] ALL APPLICABLE [2Range []Dishwasher F1Garbage Disposal 12Dryer ElFan OR Blower F1Furnace F1A/C [Electric Sign fi]Motors F1Gas Pumps IZIOther F1Water Heater DESCRIPTION OF ALL WORKBEING DONE (/.o'~ ne~3 c{eCuitS in 'Lab and .. (J3) 12Or Recep3.~3c./c~ ins'kalT~d in nCu~nit:.u~e,. VALUE (Including labor and all materials including light fixtures) MASTER ELECTRICIAN ~b0~ C~.