HomeMy WebLinkAbout0098727 EOSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
'-' ClT~' OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
612 OTTER AVE Owner MARY B LADWIG
NICOLET ELECTRIC INC Category 623- Residential-Duplex Additio~/RemodE
~ New 0 Change 0 Temp I Type ~ Overhead
Circuits 0
Amps 0
Switches 0
No 98727
Create Date 11/05/2002
Plan
(~) _.U_n. ~ e.r~r~_~_d___ J
Fixtures 0
Receptacles 0
Appliances
Use/Nature of Duplex/AFTER THE FACT/Rewire furnace and water heater
Work
Fees: Valuation
Issued By: /
$300.00 Plan Approval
$0.00 Permit Fee Paid $120.00
Date 11/20/2002
[] Permit Voided
In the performance of.f.f~this work I aj;]i'ee to perform all work pursuant to rules governing the described construction.
Signature ~/~~~~ Agent/Owner
Date
Address PO Box 48 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 \V.A. TEE'
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 m 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
CHECK [] ALL APPLICABLE
USE CATEGORY
[] Single Family
SERVICE I~New
F1Change
[~uplex []Multi-Family
DTemporary
F1Not Applicable
[]Rental
TYPE
[]Commercial []Industrial
FIOverhead [:]Not Applicable
I-IUnderground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles #
Phase
Amps Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
F1Range ~/ishwasher F1Garbage Disposal
F1Fan OR Blower mrurnace r-IA/C
I-IMotors FIGas Pumps DOther
....
F1Dryer [~ater Heater
F1Electric Sign
VALUE (Including labor and ~~~~~ures) $
MASTER ELECTRICIAN
3/02