HomeMy WebLinkAbout2002-Electric (fan & light) 0 CITY OF ,OSHKOSH No 94657
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1628 RIVER MILL RD Owner ROBERT A GLUTH Create Date 05/24/2002
Contractor WITZKE ELECTRIC Category 612 - Residential - Single Family Addition /R Plan
Service 0 New 0 Change 0 Temp Type 0 Overhead 0 Underground
Volts Circuits 1 Fixtures 2
Mips 0 Switches 2 Receptacles 0
Appliances
Use /Nature of SFR/Wiring for fan & back door light.
Work
Fees: Valuation $500.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: V Date 05/24/2002
❑ 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 PO BOX 102 155 E PACKER AVE OSHKOSH WI 54903 - 102 Telephone Number 920 - 235 -6572
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084 OfH
ON THE WATER
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
• 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 doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account p
DATE 5 -93 --o a
JOB ADDRESS /4 a $
OWNER 0 6 � l
CONTRACTOR V V l +?k EA eLirl G
CHECK E1 ALL APPLICABLE
USE CATEGORY
[Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead [2Not Applicable
❑Change IffiNot Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER •
Volts / Receptacles # Circuits #
Phase
Amps Switches # c Fixtures # c
CHECK E1 ALL APPLICABLE
❑Range ❑Dishwasher ❑Garbage Disposal ❑Dryer ❑Water Heater
❑Fan OR Blower ❑Furnace ❑A/C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK,BEING DONE
P` • o C - eF e , oe(
VALUE (Including labor and all m t rial� incl ng li fixtures) $ gces
MASTER ELE CTRICIAN P• ' 1
•
0 260 3/02