HomeMy WebLinkAbout0098726 EOSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
~cITY'bF OSHKOSH
ELECTRIC PERMIT- APPLICATION AND RECORD
616 OTTER AVE Owner MARY B LADWIG
NICOLET ELECTRIC INC Category 623 - Residential-Duplex Addition/RemodE
~) New (~) Change O Temp I Type (~ Overhead
Circuits 0
Amps 0
Switches 0
No 98726
Create Date 11/05/2002
Plan
(~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of Duplex/AFTER THE FACT/Rewire fumace and water heater
Work
Fees: Val~p.
Issued By:¢
$300.00 Plan Approval
$0.00 Permit Fee Paid $120.00
Date 11/20/2002
[] Permit Voided
In the performance of.f.,this work I aclree to perform all work pursuant to rules governing the described construction.
S ig
nature
Date
Address PO Box48 Mountain WI 54149 - 48 Telephone Number 715-276-9667
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
O/HKO/H
ON THF WATER
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO 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 []
JOB
OWNER
CHECK [] ALL APPLICABLE
USE CATEGORY ~Dup
E3Single Family lex
DMulti-Family
SERVICE F1New
F1Change
V1Temporary
F1Not Applicable
F1Rental
TYPE
DCommercial Ellndustrial
FIOverhead DNot Applicable
FIUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles #
Phase
Amps Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
[:]Range nDishwasher FIGarbage Disposal
[:]Fan OR Blower ~tF~umace mA/C
V1Motors [2Gas Pumps F1OtheL _
DESCRIPTION OF ALL WORK BEING DONE ~',:Jr ~ 7~7,~. C~
[:IDryer
F1Electric Sign
ter Heater
VALUE (Including labor and all mg~erials incl~.uding light fixtures)
MASTER ELECTRICIAN ~~M~~tJX
3/02