HomeMy WebLinkAbout0101181-Electric (dishwasher; light fixtures)OSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
225 N EAGLE ST
VAN ERT ELECTRIC
[~ New (~ Change (~ Tamp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner BETHEL HOME INC
Category 643- Commercial-Addition/Remodels
Type I~ Overhead
Circuits 0
Switches 0
No 101181
Create Date 05/01/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of COMM/New dishwasher connect & replace 4 existing light fixtures with new. *Job #F1556AA.
Work
Fees: Valuation
Issued By:
$2,500.00 Plan Approval $0.00 Permit Fee Paid
$75.00
Date 05/01/2003
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 2000 PROGRESS WAY KAUKUANA WI 54130 - 0 Telephone Number
920-766-3888
__vAs ERT
City of Oshkosh
Division of InSl~ction Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-50~4
ELECTRICAL PERMIT APPLICATION
All/nfoHrtation after bold categories must bc provided.
Incomplete applications w/Ii not be processed,
· Application(s) and fee(s) can bc brought to City Hall. Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh ~ 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus '
normal perr~t fcc. which ever is ~eater.
OR
If_you are a contraator, part#cfp_atfng in the Permit, Fee Acco_u~tt_Sv$1e.m and_have..ad, eaua.te .fund~, chec~ _h.
lf vo~t want this t~rocgssed th_rough your account ?
co rn , cro
CHECK E ALL APPLICABLE
USE CATEGORY
r'lSingJc Family I-'lDuplcx f'lMulti-Family
SERVICE r'tNcw ~Temporary
f-IChang~ /~i[Not Applicable
[-1Rental XCommcrcial E3Industrial
TYPE f=lOverhead ~ot
Applicable
KlUnd~rground
FILL IN ~ APPROPRIATE BLANK WITH ~ NUMBER
Volts -- / Receptacles #. CircUits
Phase
Amps Switehes # i~rgt u res
CHItCK [] ALL APPLICABLE'
CIRan~e ElDishwasher ~Oarbage Disposal I-IDry~ F'lWatcr Heater
f=lFnn OR Blower r'lPumace ~A/C f'lEl~ctrie Sign
ClMotors r=ioas Pumps J~Other _
DE$CRIP'J~ON OF ALL WORK BEING DONE ~~ ,~,~'A~,~A~' t~
VALUE Ongludtng labor an~! .11 materials incl.d]ng light fixtures)
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