HomeMy WebLinkAbout0096954-Electric (receptacle) i CITY OF OSHKOSH No96954
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1207 MAGNOLIA AVE Owner JIM WITZKE Create Date 08/29/2002
Contractor WITZKE ELECTRIC Category 612 - Residential - Single Family Addition /R Plan
Service p New 0 Change 0 Temp Type 0 Overhead 0 Underground
Volts Circuits 1 Fixtures 0
Amps 0 Switches 0 Receptacles 0
Appliances
Use /Nature of SFR/ Install new feeder to recp.
Work
Fees: Valuation $125.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: lJ1(V\ Date 08/29/2002
0 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
( 4—
Division of Inspection Services
P.O. Box
Oshkosh, WI WI 54903-1130
Phone (920) 236 -5050
Fax (920) 236 -5084 OJHKOJH
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 �]
DATE -as, ^O Q
JOB ADDRESS ,010 ? •vek.zct ev■■....'e
OWNER (i • tk-e
CONTRACTOR VV i - t - zke EI c f r
CHECK H ALL APPLICABLE
USE CATEGORY
pSingle Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE ❑New ❑Temporary TYPE ❑Overhead )E1Not Applicable
❑Change rTNot Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER •
Volts / Receptacles # Circuits #
Phase
Amps Switches
Fixtures #
CHECK H 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 DONE z L k)., <�
JO
is VA LUE (Including labor and all m t rial incl ng li fixtures) $ /as
MASTER ELECTRICIAN 1 "t, A ao
3/02