HomeMy WebLinkAbout0098073-Electric 0 CITY OF OSHKOSH No 98073
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2395 SHORE PRESERVE DR Owner THOMAS S BELTER Create Date 10/07/2002
Contractor ALL BRIGHT ELECTRICAL SERVICES Il` Category 611 - Residential -New Single Family Wirin Plan
Service 0 New O Change O Temp Type O Overhead 0 Underground 1
Volts 120 / 240 Circuits 0 Fixtures 0
Amps 200 Switches 0 Receptacles 0
Appliances Range, Dishwasher, Garbage Disposal, Dryer, Furnace, A/C
Use /Nature of NSFR
Work
Fees: Valuation $9,000.00 Plan Approval $0.00 Permit Fee Paid $165.00
Issued By: Date 10/18/2002
0 Permit Voided
In the performan is work I a ee perform all work pursuant to rules governing the described construction.
Signature /// .6 / Va 2 Date A �
Agent/Owner
Address 8455 S OAKWOOD AVE NEENAH WI 54956 - 0 Telephone Number 920 - 836 -2883
City of Oshkosh
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 re sult in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds. check here
if you want this processed through your account ❑
DATE /D /f1/ 7
JOB ADDRESS li 367c /vog r /�/ . /-/aft ifriXesiR(/=
OWNER j r'i T/1'
CONTRACTOR //L L MT-6y 7 .E G
CHECK EI ALL APPLICABLE
USE CATEGORY
0 Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE ,ONew ❑Temporary TYPE ❑Overhead ❑Not Applicable
❑Change ❑Not Applicable 21Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts /20 / f0 Receptacles # Circuits #
Phase /
Amps ZOO Switches # Fixtures #
CHECK Fa ALL APPLICABLE
erRan ]Dishwasher EfGarbage Disposal ,$Dryer ❑Water Heater
❑Fan OR Blower -6Fumace $A /C ❑Electric Sign
❑Motors ❑Gas Pumps ❑Other
DESCRIPTION OF ALL WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $
MASTER ELECTRICIAN ��2 e/t-
• 3/02