HomeMy WebLinkAbout0100687-Electric (repair)OSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
40 W 10TH AVE
WITZKE ELECTRIC
[~ New (~ Change (~ Temp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner WISCONSIN HOUSING & ECONOMIC DEV
Category 623 - ResidentiaI-DuplexAddition/Remodel
Type I~ Overhead
Circuits 6
Switches 3
No 100687
Create Date 04/08/2003
Plan
~ Underground
Fixtures
Receptacles
13
13
Appliances RANGE
Use/Nature of DUPLEX/ELECTRICAL IMPROVEMENTS & REPAIRS. ABOVE TO BE FIXED IN WALLS.
Work
Fees: Valuation
Issued By:
$2,445.00 Plan Approval $0.00 Permit Fee Paid
$75.00
Date 04/08/2003
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 PO BOX 102 155 E PACKER AVE OSHKOSH WI 54903 - 102 Telephone Number
920-235-6572
APR. ?.2003 2:56PM WITZKE ELECTRIC N0.212 P.2/3
Division of Inspection Services
ILO. Box 1130
Or, hkosh, WI $490t-1130
Phoae (920) 2364050
Fax (920) 23~-$084
ON TH~ WAT~
ELECTRICAL PERMIT APPLICATION
All h,formation after bold categories must be provided.
Incomplete applicaliom will not be procured.
· · Applicatien(a) and fee(s) can be brought to City Hail, Room 205 or mailed to I~spcction Ser,,dces, PO Box 1128,
OsMcosh WI '54903-1128. Commencing work without permit(i) will result in ices being ~loublcd or $100.00 plus 1~c
normal permi: fee, wkich ever is greater.
OR
~e a contractor t~arricil~atf~e i~ tlle..~tnft Fee Ac~t~$wt~m and haye adeouate funds, check here
if you want thi~ ~rocezsed tltr.~.ugh 'your account ~[ - "
Cl~CK ii~ ALL APPLICABLI:
TEGORY
Family ClDuplex EIMulti-Family E~RentaI
8ERVICI~ CINew Cl_T_e_..mt~at, y TYPE
I-tChange li~,~lSt Applicable
ElCommercial Ellndu$~ial
Overhead o[~t~pplicable
ClUuderltround
:FILL IN TI-~. APPROPRIATE BLANK WITH TIrI~ NUMBER
Volts . / .... Receptacles #, /._~
Phase
Amps ,, Switches # ,,~
Circuits
Fixtures
gALL APPLICABLE
ClDishwasher
r'lFan OK Blower I"lFurnace
~Mo tots 1-1Gas Pumps
r'lOarbale Disposal C]Dryer CIWater Heater
CIA/C ClElcclric Sign
DOther
DESCRIPTION OF ALL WORK, BEING DONE
VALUE (Includini~ labor and aH nl~t- ~ia:i In~:l;/rll ,litflxture,) $___~_~_~ ~