HomeMy WebLinkAbout0101636-Electric (kitchen remodel)OSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
Amps
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
813 E NEW YORK AVE
ZIMMER ELECTRIC LLC
~ New O Change O Temp
Owner
Category
Circuits
Switches
PAUL S LAFONTAINE
612 - Residential-Single Family Addition/R
Type (~ Overhead
0
0
No 101636
Create Date 05/20/2003
Plan
(~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of ~FR/Kitchen remodel.
Work
Fees: Valuation
Issued By:
$400.00 Plan Approval
$0.00 Permit Fee Paid $20.00
Date 05/20/2003
[] Permit Voided J
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 400 E SCOTT ST OMRO WI 54963 - 0 Telephone Number
920-685-2387
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 TNF 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
l_f ¥ou are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account~>
· DATE
OWNER
CONTRACTOR
CIIECK [] ALL APPLICABLE
ATEGORY
le Family VIDuplex VIMulti-Family IZIRental
SERVICE VINew V1Temporary TYPE
FIChange F1Not Applicable
V1Commercial Vllndustrial
F1Overhead VINot Applicable
F1Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles #
Phase
Amps Switches #
Circuits fl
Fixtures #
CHECK [] ALL APPLICABLE
F1Range F1Dishwasher V1Garbage Disposal
F1Fan OR Blower VIFurnace [2A/C
V1Motors V1Gas Pumps V1Other
DESCRIPTION OF ALL WORK BEING DONE //~'
F1Dryer
F1Electric Sign
F1Water Heater
VALUE (Including labor and all materials including light fixtures)
MASTER ELECTRICIAN
3/02