HomeMy WebLinkAbout0101773 EOSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
1095 W 19TH AVE
WITZKE ELECTRIC
[~ New (~ Change (~ Temp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner ARLEIGH/FRANCES HUBBARD
Category 612- Residential-Single Family Addition/Ret
Type I~ Overhead
Circuits 2
Switches 0
No 101773
Create Date 05/28/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances Dryer
Use/Nature of SFR/Install 110V recp for gas range and 220V 4 wire recp for dryer.
Work
Fees: Valuation
Issued By:
$300.00 Plan Approval $0.00 Permit Fee Paid
$20.00
Date 05/28/2003
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. 87. 2883 3: 34PM
P.O. Box 1130
Oshkosh, W154903-1 ! 30
Phone (920)
Fax (920) 236-5084
WITZKE ELECTRIC
ELECTRICAL PERM IT APPLICATION
Ail i~fotrnation 81~et bold categories muat be provided.
IncompW~e applica~ion~ ~ll not be processed.
H0.677
P. 3/3
· Application(s) md fee(s) cs bc brought to City Hall, Room 205 ot mailed to L~ecdon Service~, ?O Box 1128,
Os~o~ ~ '54903-1128. Go~c~ wo~ without pe~l(s) wi~ reset in fees being doubl~ or $100.00 plus
no~ p~t ~e~ wMch cyst is
OR
If v~u are a Contractor ~rti~atin~n tge Pe~mlt F~e ~aunt ~v~t~ an~ Aav~adeauate.fund~A~ck h~r~
(~ v~an~ t~is ~roc~ed~rou~h v~r a~ount ~
CHECK [] ALL APPUCABLF.
I~in$1¢ Family ODupl~x ~Mu1~i-Fara[ly
SEi~V'~CE ON~w ~_'r~orary
ClChange Lsq~ot Applicable
r"II~cntal
TYPE
ClCommarcial Olndustrial
OOverhead ~ot Applicable
OUnderground
FILL LN THE APPROPRIAT~ BLANK ~,~ITH TI~
Volt: / Receptacles #_.
Phase -
Amps Switches #
Circuits
FL~tures
CHI:CK I~ ALL A-PPLIC.~BLE
ORange ElDishwasl'ier ClGarbagc Disposal i~er
CIFan OR Blower OFumace EI,-VC OElecmc Si~
~Motors O Gas P~ps ~ O~er
I"lWater Hea:er