HomeMy WebLinkAbout2003-ElectricOSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
1910-1964 S KOELLER ST
VAN ERT ELECTRIC
[~ New (~ Change (~ Temp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner CAPITAL AMERICA #014037 TAX REP Y
Category 643- Commercial-Addition/Remodels
Type I~ Overhead
Circuits 0
Switches 1
No 101180
Create Date 04/02/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of 940/Credit Union Tenant Space/Alterations to Teller area: Move ATM, light switch & counter top. * Job #F1556AB.
Work
Fees: Valuation
Issued By:
$1,000.00 Plan Approval $0.00 Permit Fee Paid $45.00
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
05/01/02
09:47 FAX 920 766 0883
VAN £RT ELECTRIC
~003/003
Ciqt of Oshkosh
DiviSion of Inspection Services
p.o, Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
l:ax (920) 236-~084
ON r~e WA'fiR
ELECTRICAL PERMIT APPLICATION
All information after bold categories must bc pt#vialed.
Incomplete applications will not be processed.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or marled to Inspection Services, PO Box ! 128,
Oshkosh WI 54903-1128. Commen~ing work without pennit(s) will r~sult in fees b~ing doubled or $100.00 plus'
normal permit fee, which ever is greater.
OR
I/you are a contractor participating in the Permit~Fee Account S]~stem and.have_a, dequatR funds, check h.
~f vou want..thir processed through your account
CHECK I~ ALL APPLICABLE
USE CATEGORY
DSingle Family [2Duplex
EIMulti-Family ClKental
TYrE
SERVICE l-INew
l-IChange
~i]lqot Appli~ble
/~Commereial ElIndustrial
QOve~head /~[Not Applicable
I~Underground
]KILL IN ~ APPROPRIATE BLANK WITH THE NOIVlBRR
Volts , __ ! ,, Receptacles # Circuits
Phase
Amps Switches # t/ Fixtures
Ci~ECK [~[ ALL APPLICABLE
VIRange VIDishwasher VlOarbage Disposal ~lDryer VlWater Heater
VIFan OR Blower ClFumac, e VIA/C l-lElecttic Sign
VIMotors ~Ga~ Pumps ~l~Other
/
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