HomeMy WebLinkAbout0100528 EOSHKOSH
ON THE WATER
Job Address 513 N MAIN ST
Contractor TRUCK ELEC
Service [~ New (~ Change (~ Temp
Volts
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner 3710 LISBON LLC
Category 643- Commercial-Addition/Remodels
Type I~ Overhead
Circuits 0
Switches 0
No 100528
Create Date 03/31/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances Water Heater
Use/Nature of COMM/Wire water heater.
Work
Fees: Valuation
Issued By:
$200.00
Plan Approval
$0.00 Permit Fee Paid
$20.00
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 690 W 3 RD AVE OSHKOSH WI 54902 - 0 Telephone Number
(920) 233-7191
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
OJ'HKO./H
ON THF \¥ATER
· 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
JOB ADDRESS
CHECK [] ALL APPLICABLE
USE CATEGORY
[2Single Family
SERVICE F1New
E]Change
[2Duplex DMulti-Family
[]Temporary
[]Not Applicable
ElRental
TYPE
~o~ercial Ellndustrial
F1Overhead F1Not Applicable
[]Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles #
Phase
Amps Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
FlRange F1Dishwasher
[]Fan OR Blower F1Fumace
[2Motors I-IGas Pumps
[2Garbage Disposal
[]A/C
ElOther
DESCRIPTION OF ALL WORK BEING DONE ~]~/~'
[3Dryer ~ater Heater
[]Electric Sign
VALUE (Including labor and ' including light fixtures)
MASTER ELECTRICIAN / /~/~/ / ~/)J ~ ~... U' /~'"' ~ ~ /
I
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3/02