HomeMy WebLinkAbout0101281 EOSHKOSH
ON THE WATER
Job Address 460 AVIATION RD
Contractor TRUCK ELEC
Service [~ New (~ Change (~ Temp
Volts
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner GAMBINUS
Category 643- Commercial-Addition/Remodels
Type I~ Overhead
Circuits 0
Switches 0
No 101281
Create Date 05/05/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of COMM/Replace existing light fixtures.
Work
Fees: Valuation
Issued By:
$1,000.00
Plan Approval
$0.00 Permit Fee Paid
$45.00
Date 05/05/2003
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 690 W 3 RD AVE OSHKOSH WI 54902 - 0 Telephone Number
(920) 233-7191
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
O/HKO/H
ON THF k,V!~.~
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, Pt_, 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 []
OWNER
CONTRACTi~R
CHECK [] ALL APPLICABLE
USE CATEGORY
I-ISingle Family
SERVICE I-INew
F1Change
mDuplex FlMulti-Family
[3Temporary
[3Not Applicable
ElRental
TYPE
~ommercial [] Industrial
F1Overhead EINot Applicable
[3Underground
FILL IN TRE APPROPRIATE BLANK WITH THE NUMBER
Volts [ Receptacles #
Phase
Amps Switches #
Circuits
Fixtures
CHECK [] ALL APPLICABLE
[3Range ElDishwasher [3Garbage Disposal
[3Fan OR Blower I-IFumace [3A/C
F1Motors I-IGas Pumps []Other
)ESCRIPTION OF ALL WORK BEING ~)QNE _ (-4~F3 L~:),-q_L~
EIDryer
FIElectric ~ign
[3Water Heater
VALUE (Including labor and a)l/mat/r
/!
MASTER ELECTRICIAN/ //
Iincluding light fix[u, re~ $ ,/0OO~"
3/02