HomeMy WebLinkAbout0100517 EOSHKOSH
ON THE WATER
,Job Address 307 LIBBEY AVE
Contractor WES TOMASEK ELECTRIC
Service [~ New (~ Change
Volts 115 / 230
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner JEFF/MAUREEN LECHNIR
Category 634- Residential-Service Change
Amps 200
~ Temp
Type I~ Overhead
Circuits 0
Switches 0
No 100517
Create Date 03/31/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Changing 100 amp service up to 200 amps.
Work
Fees: Valuation
Issued By:
$800.00 Plan Approval
$0.00 Permit Fee Paid
$35.00
Date 03/31/2003
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 5224 GINNOW RD OMRO WI 54963 - 0 Telephone Number
582-4178
OSHKOSH
ON THE WATER
Job Address 307 LIBBEY AVE
Contractor WES TOMASEK ELECTRIC
Service ~ New O Change
Volts 115 / 230
CITY OF OS~-IKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Amps 200
(~ Temp
Owner
Category
Circuits
Switches
JEFF/MAUREEN LECHNIR
634 - Residential-Service Change
Type _(~ Overhead
0
0
No 100517
Create Date 03/31/2003
Plan
~) Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/Changing 100 amp service up to 200 amps.
Work
Fees: Valuation
Issued By: ~
$800.00 Plan Approval
$0.00 Permit Fee Paid
$35.00
Date 03/31/2003
[] Permit Voided
In the performan~ ~ this~ ?gree to perfo~,~ork pursuant to rules governing the described construction.
*"- M' ~ / ' Agen~Owner
Date
Address 5224 GINNOW RD OMRO WI 54963 - 0 Telephone Number
582-4178
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
O/HKQ/H
ON TNF \MATER
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 Four account []
DATE ,~"'~T,,,/'-~9-.-.~'
ADDRESS
CHECK Iii ALL APPLICABLE
USE CATEGORY
~Single Family
SERVICE F1New
~Change
F1Duplex []Multi-Family
[2Temporary
[2Not Applicable
FIRental
TYPE
F1Commercial Fllndustrial
F1Overhead [2Not Applicable
J~Underground
FILL IN TIlE APPROPRIATE BLANK WITH THE NUMBER
Volts //~' /~J O Receptacles #
Phase /
Amps ~. <~0,~'"'~/) ~ Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
F1Range [2Dishwasher F1Garbage Disposal
DFan OR Blower [3Furnace [2A/C
[] Motors [] Gas Pumps [] Other
F1Dryer
FIElectric Sign
DESCRIPTION OF ALL WORK BEING DONE
/fo
FlWater Heater
VALUE (Including labor and all materials including light fixtures)
3/02