HomeMy WebLinkAbout0102047-Electric (x-ray)OSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
1855 S KOELLER ST
EXCELLENCE ELECTRIC, INC.
I~ New (~ Change (~ Temp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner OSHKOSH LASALLE 93
Category 843- Commercial-Addition/Remodels
Type ICI Overhead
Circuits 0
Switches 0
No 102047
Create Date 08/09/2003
Plan
~] Underground
Fixtures
Receptacles
Appliances
Use/Nature of CLINIC/Wiring for new x-ray. *Job #30625.
Work
Fees: Valuation
Issued By:
$9,407.00
Plan Approval
$0.00 Permit Fee Paid
$180.00
Date 06/09/2003
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 321 E MAIN ST PO BOX 78 LITTLE CHUTE WI 54140 - 78 Telephone Number
(920) 687-2442
City of Oshkosh
Division of Inspection Services
P.O. Box 1130 ' x~. ~xj
r~'-~ OshkoSh, WI 54903-I 130 [%¥A
ELEGTRICAL
PERMIT AP LIC IO O
All ~bmtion after bold categories mua~~
·
Application(s) and fee(s) c~ be brought to Ci~ Hall, Room 205 or ~iled to hspecti~~F3, PO Box 1128,
' Os~osh WI 54903-1128. CommenCing work without pemit(s) ~11 result in fees being ddfi~or $100.00 plus the
nomal pemit fee, w~ch ever is ~eater.
OR
If.Fou are a contractor participating ~n the Permit Fee ~ccount System and have adequate funds, check here
ff Fou want this processed through ~°ur account ~
DATE
JOBADDRESS J~"~' ,~. [~Om~ ~
CONTRACTOR
CHECK [] ALL APPLICABLE
USE CATEGORY
~Single Family E3Duplex
I:lMulti-Family
SERVICE F1New
FIChange
[3Temporary
,~lot Applicable
I-IRental
TYPE
FILL IN TI-1F~ APPROPRIATE BLANK WITH TglE NUMBER
Volts · / Receptacles #
Phase
Amps Switches #
EICommercial r-llndustrial
F1Overhead J~lXlot Applicable
[3Underground
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
[3Range
F1Fan OR Blower
FlMotors
F1Dishwasher
ElFumace
I-IGas Pumps
VlGarbage Disposal
[3A/C
~Other
[3Dryer
[3Electric Sign
DESCRIPTION OF ALL WORK BEING DONE
[3Water Heater
(InCluding labor and all materials including light fixtures) $ ~/4~ F~--'O
,,,. /3P. oO
3/02