HomeMy WebLinkAbout0095154-Electric CITY OF OSHKOSH No95154
,0 OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3733 GLENKIRK LN Owner ROBERT /SARAH GUTJAHR Create Date 06/14/2002
Contractor WITZKE ELECTRIC Category 611 - Residential -New Single Family Winn Plan
Service 0 New 0 Change 0 Temp Type 0 Overhead 0 Underground
Volts 120/240 Circuits 0 Fixtures 0
Amps 100 Switches 0 Receptacles 0
Appliances
Use /Nature of SFR/ Wiring for new mobile home.
Work
Fees: Valuation $1,000.00 Plan Approval $0.00 Permit Fee Paid $45.00
Issued By: 11/1 Date 06/14/2002
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 •
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903 -1130
Phone (920) 236 -5050
Fax (920) 236 -5084 Of HKOJ H
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 h -13 -oa
JOB ADDRESS .� . S 6/01hr,
OWNER Robe i CJC,[ld r
CONTRACTOR W C Zke
CHECK H ALL APPLICABLE
U E CATEGORY
Single Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
SERVICE�]New ❑Temporary TYPE ❑Overhead ❑Not Applicable
D hange ❑Not Applicable ,Jnderground
•
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts (c2 Receptacles # Circuits #
Phase
Amps /(?o 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 BEING DONE i » / / r MOAdo, him
VALUE (Including labor and all m t ria4 incl ng li fixtures) $ /Doo O
MASTER ELECTRICIAN �, 4 . 0 797/ c?
/..)6•01)
IL 00
3/02