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HomeMy WebLinkAbout0101701-Electric (wiring)OSHKOSH ON THE WATER CITY OF OSHKOSH ELECTRIC PERMIT - APPLICATION AND RECORD JobAddress 435 HIGH AVE Owner ST PETERS CONG Create Date 05/22/2003 Contractor TRUCK ELEC Category 643- Commercial-Addition/Remodels Plan Service I~ New (~) Change (~) Temp Type I~ Overhead ~ Underground Volts Circuits 0 Fixtures Switches 6 Receptacles Amps 0 No 101701 Appliances Use/Nature of COMM/ Install new wire and devices in locker rooms, washrooms and hall. Remove old & install new 2x4 drop in fixtures in meeting room. Work Fees: Valuation Issued By: $4,000.00 Plan Approval $0.00 Permit Fee Paid $90.00 Date 05/22/2003 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 WATER · Application(s) and fee(i) :~an~be brought to City Hall, Room 205 or mailed to In.~pection Services, PO Box 1128, Oshkosh WI 54903q 128i Commencing work without permit(s) will result in fees being doubled or $100.00 plus the normal permit fee, which ~ve? is greater. OR ..... -, !" !~." If you are a contractor pa}'tt~cipating in the Permit Fee Account System an~.. have adequate funds, check here if v, ou want this processed through.your account [] o /. CHECK [] AEL APPLICABLE USE CATEGORY F1Single Family SERVICE C]New EIChange FIDuplex IZIMulti-Family EiTemporarY Eliot Applicable F1Rental [[tC~ommercial IZllndustrial TYPE FIOverhead Eliot Applicable F1Underground FILL IN THE APPROPRIATE BLANK WITH THE NUMBER Volts / Phase Amps CHECK [] ALL APPLICABLE Receptacles # ~' Circuits # Switches # ~. Fixtures # rlRange FIDishWasher F1Garbage Disposal FIDryer FlWater Heater rlFan OR Blower rlFurnace EIA/C i-lElectric Sign IZIMotors IZIGas Pumps DOther DESCRIPTION OF ALL WORK BEING DONE ~~ d~.~¢~-3 &_3t 1~ VALUE (Including labor and~'~terials including light fixtures) $ ~. f MASTERELECTRICJ /h.,t~_.~ ~-'~t.,/~ / .... / . 3/o2