HomeMy WebLinkAbout0104680-Electric (laundry room)OSHKOSH
ON THE WATER
Job Address 1013 EVANS ST
Contractor BELL ELECTRIC
Service [~ New (~ Change (~ Temp
Volts
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner VICTORIA L BELTRAN
Category 612 - Residential-Single Family Addition/Ret
Type I~ Overhead
Circuits 2
Switches 0
No 104680
Create Date 10/08/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances Washing machine
Use/Nature of SFR/re-locating washing machine & dryer.
Work
Fees: Valuation
Issued By:
$300.00 Plan Approval $0.00 Permit Fee Paid $20.00
Date 10/08/2003
Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 1303 Midway Rd Menasha WI 54952 - 0 Telephone Number
920-886-6589
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
From:
10/08/2003 07:31 #407 P.O03
ELECTRICAL PERMIT APPLICATION
/~1 inforn~tion ~r bol& cave,tiles m~t be ~mvlded.
~LL ~ ~E APPROPRIATE BL~ WITH THE N'f~f~ER
Volts ~ ~ ~ ,, , C~s ·
Ph~e
Amps Swftch~ ~ , ~u~s ~
t/' ( Sig~urc~'f Company Officer)
~rin r'~,la~me orOfficcr) (Date)
From:
O~t. OG
10/08/200 07:32 #407 P.O04
Electric Installation Verification
(Bl~ctrical Contractor N~ne) -
(Ad.ss) O ' (City) (S~e) (~p Codc~
have been contracted to perfo~ ~ectffc ins~l,gon wor~ for ~e~ f~.~ ,
at the follo~g add.ss: / ~/~
(Ad&~ss whe~ work ~11 be p~)
~e nature of~ work consists of: (~eck One or D~e~be ~e Namr~ of Wo~)
~ Reco~on or new circuit for ~la~ H~ng P]~ ~d/~ ~C C~er.
R~co~on or new c~cuit for ~]a~ement Elec~c Water H~t~ or pow~ v~ed
w~er beater.
R~o~ion of ~e S~i~e ~n~an~e C~le, Me~ Box, al~a~o~ to
~d ]i~ng ~x~ez due to ~di~ / soffi~ imml~ti~. Nme: N~
appliances / fixture.
~ New ~rc~t for ~e addition of ~C to ~ i~ivM~l ~effia~ a~r ~o~e or ~
indivi~ syaems in a duplex or condomini~), including ~lui~
elec~c~ ou~e~.
~ O~h~
The value of this work is $_ ~ .~t:~)~./0
I hereby verify :his work will be performed by an employee of:his company and further verity
thc r¢connccrion / installation will be done in compliance with manufacturer and Elecrac code
requirements.
~Si~,~ure of Company Officcri
.:5'e, /v'-- ?-'o 3
(Print'Name of Officer) (Date)