HomeMy WebLinkAbout0102214 EOSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
1901 VINLAND ST
VAN ERT ELECTRIC
[~ New (~ Change (~ Temp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner JOSEF E SATTAKEH/ZAHRA SHAFI
Category 612- Residential-Single Family Addition/Ret
Type I~ Overhead
Circuits 0
Switches 0
No 102214
Create Date 06/16/2003
Plan
~ Underground
Fixtures
Receptacles
0
12
Appliances ¢Vater Heater
Use/Nature of SFR/MIsc interior wiring. #Job #F1563-AT.
Work
Fees: Valuation
Issued By:
$1,300.00
Plan Approval
$0.00 Permit Fee Paid
$60.00
Date 06/16/2003
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 2000 PROGRESS WAY KAUKUANA WI 54130 - 0 Telephone Number
920-766-3888
05/13/02 14:27 FAX 920 768 0883 VAN ERT ELECTRIC ~001
City of Oshkosh
Division of lnspec.6on Services
P.O. Box 1130
Oshkosh, WI 54903- i 130
Phone (920)
Fax (920) 2~64084
ELECTRICAL PERMIT APPLICATION
Alt information after bold categories must be provided.
Incomplete applica~.ons w~lI not bc processed.
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 112g,
Oshkosh WI $4903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plu.~
normal permit fee, which ever is greater.
OR
l~yoy are a contraatf~r particilzatin~ ia the Perm~lFee AcCount System and have adequdte tund~, c'heck t
if_you wa~t this procer~.d throu~ ~ ' '
C~.CK [] ALL APPLICABLE
_~ECATEGORY
ingle Family ElDuplex 171Multi. Family
SERVICE VlNew
12.Temporary
/'1Change ~Not Applicable
FILL IN ~ APPROPRIATE BLANK WITH ~ NUMBER
Vo[B ... ! ,. Receptacles # J~
Ph~e
Amps Switches #
i-llZental I'lCommereial ~Industrial
TYPE [-IOverhead ~Not Applicable
DUn&rground
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
f=lRange ElDishwazher DGarbage Disposal DDr~a-
rlFan OR Blower [2Furnace f=IA/C DElectric Sign
DMotors [] Gas Pumps []Other
D scv. n, TtO Or wO S '.IN OO , uoi? ,
aterHeater
VALUE (heludlng labor and ail materials including light fixtures) $
~
MASTER ELECTRICIAN ti m. &~
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