HomeMy WebLinkAbout0102501-Electric (a/c)OSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
624 W 11 TH AVE
HEATLEY ELECTRIC
[~ New ~ Change ~ Temp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner HERMAN B LEITZ
Category 612- Residential-Single Family Addition/Ret
Type I~ Overhead
Circuits 0
Switches 0
No 102501
Create Date 06/19/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances ~,/C
Use/Nature of SFR/Installing central air conditioning.
Work
Fees: Valuation
Issued By:
$150.00
Plan Approval
$0.00 Permit Fee Paid
$20.00
Date 06/27/2003
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 P.O. BOX 507 RIPON WI 54971 - 0 Telephone Number
920-748-7786
OSHKOSH
ON THE WATER
Job Address 624 W 11TH AVE Owner
Contractor HEATLEY ELECTRIC Category
Service ~) New O Change (~) Temp I
Volts Circuits
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
HERMAN B LEITZ
612 - Residential-Single Family Addition/R
Type (~ Overhead
0
Amps 0 Switches 0
No 102501
Create Date 06/19/2003
Plan
(~ Underground
Fixtures
Receptacles
Appliances A/C
Use/Nature of 3FR/Installing central air conditioning.
Work
Fees: Valuation
Issued By: ~/~
$150.00 Plan Approval $0.00 Permit Fee Paid $20.00
// [] Permit Voided 1
In the perfor~'~!~~~a e of this /,I,/'1~ ' ~'iS~;l~pursuant to rules goveming the described construction.
Signature '/~"- "¢?~~ Agent~Owner . Date
Address
/~ 507 RIPEN WI 54971 ~ 0 Telephone
Number
Date 06/27/2003
920-748-7786
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
O~--~O~ Oshkosh, wi 54903-1130
Fax (920) 236-5084
ON THE WATER
Phone (920) 236-5046
ELECTRICAL PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
t.b-rv4 LCHz.
CIRCLE ALL APPLICABLE
USE CATEGORY SINGLE FAMILY
SERVICE NEW
TYPE OVERHEAD
NO. OF FIXTURES
DUPLEX MULTI-FAMILY ~ COMMERCIAL INDUSTRIAL
SWITCHES RECEPTACLES CIRCUITS
AMPS
VOLTS / PHASE
CHECK ALL APPLICABLE
RANGE
DISHWASHER
ELECTRIC SIGN
WATER HEATER
FAN OR BLOWER
MOTORS
GARBAGE DISPOSAL DRYER
FURNACE A/CX'
GAS PUMPS OTHER
Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
VALUE i er n d' n
MASTER ELECTRICIAN