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HomeMy WebLinkAbout0101202 EOSHKOSH ON THE WATER Job Address Contractor Service Volts 128 W 21 ST AVE WITZKE ELECTRIC [~ New (~ Change (~ Tamp Amps 0 CITY OF OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD Owner KRISTI L/LORI L MATHUSEK Category 612 - Residential-Single Family Addition/Ret Type I~ Overhead Circuits 0 Switches 0 No 101202 Create Date 05/02/2003 Plan ~ Underground Fixtures Receptacles Appliances Range & Dryer Use/Nature of SFR/Install sub-panel and wire for dryer & range - 4 wire recp. Work Fees: Valuation Issued By: $500.00 Plan Approval $0.00 Permit Fee Paid $20.00 Date 05/02/2003 Permit Voided In the performance of this work I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address PO BOX 102 155 E PACKER AVE OSHKOSH WI 54903 - 102 Telephone Number 920-235-6572 MAY. 1.2I~03 2: 49PM Ci~ Of 0~ ~ivi~i~ of ~p~o~ 5~ices P,O, Box 1130 ~h, ~ ~490~-1130 Phone (920) 236.~0~0 N~ (920) 23&~0~ WITZKE ELECTRIC ELECTRICAL PERMIT APPLICATION All in£orrtntion afl=r bold c~t=$ofies must be provided, L'tcomplem applications will not be processed. N0.446 P.2/3 OJ'HK©fH ON TH~ ., · Application(s) and fcc(s) can t~ broushr to City Hall, Room 205 or mailed to ~s~ection Services, PO Box 1128, O~sh WI '5490~-1128. Go~encing work ~out pc~t(s) will resuk in fees being ~oublcd or $100,00 pl~ the OR ~.~O,u are q contractor ~rtte(~tingj~.,t~a Per~i~F~e Account 3v~tem an~deauate fund~, ch~k hel'e it yqF wa~t this nroce~xed through your ~c.ount ~ C~CK I~ ALL APPLICABLE eTEGORY Family I-IDuplex DMulti-Family SERVICE ElNew ElT?i,,.ml;~orary FlChan§e Et'Wot Applicable E3Cornmer¢ial [Z]LudustriaI ElOverhead [~'~pplicuble IZlUnderground FILL IA' TIlE APPROPIE[ATE Volts I Receptacles # Circuits Phase Amps Switches # Fixtures CHECK ~I AI, L A.?PLICABLE [~ange ~Dish,vashel' EiOarbage Disposal UF~ OR Blower ~F~ace ~C UElec~c Si~ ~Moto~ ~Gas P~ps ~Other []Water VALUE (Including tabor and all m t!rials in ~L~.STER ELECTRICIA.N ,, .d