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HomeMy WebLinkAbout2003-ElectricOSHKOSH ON THE WATER .lob Address 1175 S WASHBURN ST Contractor TRI COUNTY ELECTRIC Service [~ New (~ Change Volts 120 / 240 CITY OF OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD Owner MICHAEL L STRATZ Category 643- Commercial-Addition/Remodels Amps 100 ~) Temp Type I~ Overhead Circuits 8 Switches 5 No 100904 Create Date 04/22/2003 Plan ~ Underground Fixtures Receptacles 10 15 Appliances Use/Nature of Commercial/Domino's / Remodel to Domino's specs. Work Fees: Valuation Issued By: $2,500.00 Plan Approval $0.00 Permit Fee Paid $75.00 Date 04/22/2003 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 693 Menasha WI 54952 - 0 Telephone Number 920-727-9724 OSHKOSH ON THE WATER ,Job Address 1175 S WASHBURN ST Contractor TRI COUNTY ELECTRIC Service ~) New O Change Volts 120 / 240 CITY OF OSHKOSH Am ps 100 ELECTRIC PERMIT -APPLICATION AND RECORD ~ Temp Owner Category MICHAEL L STRATZ 643 - Commercial-Addition/Remodels Type ~_ Overhead Circuits 8 Switches 5 No 100904 Create Date 04~22/2003 Plan Q Underground Fixtures 10 Receptacles 15 Appliances Use/Nature of Commercial/Domino's / Remodel to Domino's specs. Work Fees: Valuation Issued By: .~ $2,500.00 Plan Approval $0.00 Permit Fee Paid $75.00 Date 04122/2003 [] Permit Voided In the performanc¢~ this work, agree to perform all work pursuant to rules governing the described construction. Signature ~ ./'/~ ) ~2-.,',~ ~,~,,..¢..,~.-~..,_,~ Date Agent/Owner Address PO BOX 693 Menasha WI 54952 - 0 Telephone Number 920-727-9724 City of Oshkosh Division of Inspection Services P.O. Box 1130 Oshkesh, WI 54903-1130 Phone (920) 236-5050 Fax (920) 236-5084 O_/HKO./H ON THE \~/ATER 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 m 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 ~.-22-0 ~ JO AI,. SS OWNER CONTRACTOR CHECK [] ALL APPLICABLE USE CATEGORY [3Single Family F1Duplex I-1Multi-Family I-'lRental SERVICE FINew FITemporary TYPE l-IChange .~8[Not Applicable ~Commercial [2]Industrial [:]Overhead [~Not Applicable FIUnderground FILL IN THE APPROPRIATE BLANK WITH THE NUMBER Volts }2c0 / ,~ ~ 0 Receptacles # Phase / Amps /tTO Switches # Circuits Fixtures CHECK [] ALL APPLICABLE VIRange [3Dishwasher F1Garbage Disposal VIFan OR Blower [3Furnace EIA/C [3Motors F1Gas Pumps [3Other g} X/ fi~'Dryer FIWater Heater ,[~lElectric Sign VALUE (Including labor and all materials including light fixtures) $ ~S~oo ~ 3/02