HomeMy WebLinkAbout0091060-Electric (new pedistal) CITY OF OSHKOSH No 91060
OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3739 GLENSHIRE LN Owner DANIEL/KIM WILCOX Create Date 10/29/2001
Contractor WITZKE ELECTRIC Category 612 - Residential - Single Family Addition /R Plan
Service 0 New O Change 0 Temp Type 0 Overhead • Underground
Volts 120/240 Circuits Fixtures
Amps 100 Switches Receptacles
Appliances
Use /Nature of Mobile Home /Install new pedistal & wire to mobile home.
Work
Fees: Valuation $1,000.00 Plan Approval $0.00 Permit Fee Paid $45.00
Issued By:V✓1
Date 11/02/2001
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 PO BOX 102 155 E PACKER AVE OSHKOSH WI 54903 - 102 Telephone Number (920) 235 -6572
- _v:.szcn cf :nsgect:cn Ser•
, `' 215 Church Avenue
P.O. Box 1130
Oshkosh, MI 54903-1130
Fax (920) 236 -5094
Phone (920) 236 -5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
M1
DATE / 1)- o=6. -
JOB ADDRESS 3 �eASPN tiQ ‘.%gm L C eS
OWNER i Se ^ Lac e S
CONTRACTOR WITZKE ELECTRIC INC
CHECK ALL APPLICABLE
USE CATEGORY: SINGLE FAMILY® DUPLEX❑ MULTI- FA.MILY❑ RENTAL❑
COMMERCIAL❑ INDUSTRIAL❑
SERVICE: NEW ® CHANGE ❑ TEMPORARY ❑ NOT APPLICABLE ❑
TYPE: OVERHEAD ❑ UNDERGROUND ® NOT APPLICABLE ❑
NUMBER OF FIXTURES SWITCHES RECEPTACLES CIRCUITS
AMPS /n VOLTS /ac o / a - 0 PHASE /
CHECK ALL APPLICABLE
RANGE ❑ WATER HEATER ❑ GARBAGE DISPOSAL ❑ DRYER ❑
DISHWASHER ❑ FAN OR BLOWER ❑ FURNACE ❑ A/C ❑
ELECTRIC SIGN ❑ MOTORS ❑ GAS PUMPS ❑ OTHER
DESCRIPTION OF ALL WORK BEING DONE j v�c'�•cl 83 ?e �: -q-cd 1r '
1 .3∎I s4 k. I (1 abi fe o t•r .
VALUE (Including labor and all materials including light fixtures) S
t
MASTER ELECTRICIAN
Submit payment with application. Failure to pav within 3rD days will -es -t in
f ees being doubled or $100.00 t s he normal permit fee, which _ °_= is "' eater.
OR
- =•� ::ere if you want Cnis process ✓cur acc ❑
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Electric Permit Work Card
Job Address 3739 GLENSHIRE LN Permit Number 91060 Create Date 10/29/2001
Owner DANIEUKIM WILCOX Contractor WITZKE ELECTRIC
Category 612 - Residential - Single Family Addition /R
Service • New Q Change Q Temp 0 N/A Type Q Overhead • Underground 0 N/A
Volts 120/240 Circuits Fixtures
Amps 100 Switches Receptacles
Fee $45.00 Value $1,000.00
Appliances
Use /Nature Mobile Home /Install new pedistal & wire to mobile home.
of Work
Inspections:
Date 11/8/01 Type Service Inspector Jonathan Fischer u Approved
11/8/01 could not get in. i left sticker telling to call to set up time
Date 11/12/01 Type Inspector Jonathan Fischer U Approved
11/12/01 8:45 am
Date 11/12/01 Type Service Inspector Jonathan Fischer _f Approved
11/12/01 called in
11/12/01 mailed in