HomeMy WebLinkAbout095055 Electric (wiring AC) (2) CITY OF OSHKOSH No 95055
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2111 MOUNT VERNON ST Owner THOMAS N RUSCH Create Date 06/10/2002
Contractor WITZKE ELECTRIC Category 612-Residential-Single Family Addition/R Plan
Service Q New 0 Change Q Temp Type Q_Overhead_ Q Underground
Volts Circuits 0 Fixtures 0
Amps 0 Switches 0 Receptacles 0
Appliances C
Use/Nature of SFR/Wiring for new a/c.
Work
Fees: Valuation $150.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: k V Date 06/11/2002
❑ 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
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh,WI 54903-1130
Phone(920)236-5050
Fax (920)236-5084 O1HKOIH
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 ❑
1 L'7 LU L ]/ DATE 6-16 -001,
JOB ADDRESS o4 // / • y� Y1 „ert/1Q
OWNER Ct:i' Imo, J `g/L�17. �, l�J
CONTRACTOR W1i-zKe EIez{ri.G L nc .
CHECK H ALL APPLICABLE
USE CATEGORY
.Single Family ❑Duplex ❑Multi-Family Rental ❑Commercial ❑Industrial
SERVICE ONew OTemporary TYPE DOverhead WI"ot Applicable
OChange gNot Applicable ❑Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts I Receptacles # Circuits T
Phase
Amps Switches# Fixtures
CHECK H ALL APPLICABLE
❑Range DDishwasher ❑Garbage Disposal DDryer OWater Heater
DFan OR Blower ❑Furnace A/C DElectric Sign
DMotors El Gas Pumps El Other
DESCRIPTION OF ALL WORK,BEING DONE n/ei `C (/v
I
^ E
VALUE (Including labor and all mat 1 Jitv ial5 inng lia fixtures) S f ,00
MASTER ELECTRICIAN 7 <1,-y---N -'■i"----)
i
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�G•ED