HomeMy WebLinkAbout0103963 H RECENt,
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1 ~30
Phone (920) 236-5050
Fa~ (920)2~6-5084 KO/H
All infonmfion after bold cateaories mast ben--ideal.
0r
· Application(s) and f~(s) can be brought to City Hail, Room 205 or ~iled to bspection ~e~, PO Box 1 t28,
Oshkosh WI 54903-1128. Co~encing work Mthout pem~s) will result in fees being doubled or $100.00 plus the
~onnal pemit fee, w~ch ever is ~eater.
OR
I[~ou are a contractor parlicipatin~ in the Permit [ee Account Svxtem and have adequate [unds. check her~
i{vou want this procexsed lhrou~h your account ~
$OBAUDrCSS tbgO V'd -'CtO..D %i-
CONTRACTOR
DATE
CItECK 1~I ALL APPLICABLE
USE CATEGORY
~5~Single Fmnily []Duplex [Multi-Family
rqRental [ Cormnerciat [3Industrial
FUEL ~lGas i-lEIectric F1Solid SYSTEM ElNew ~Replace
[]Oil [] Solar [] Other
TYPE
~2I~orced Air EJRadiant •Steam []A/C
[]Vent
I:tElectric
IS CLYISVINEY BEING LINED []No [~Yes - LINER SIZE
Note: All cl6mneys shall be s/zed per the BTU's be/ng vented.
[]Hot 'Water •Suppl. ~Con. Burner
& MANUFACTUILER FUt'-L-
CHIMNEY TYPE
EI~AT LOSS
BTU RATE
[]Chinmey A
[3As Approved
[]As Per Plan
D Chi~rmey B
•Existing
[] Variable
ElDirect Vent
[]Not Applicable
[]Other Value
•Other
DESCRIPTION Or AI,L WORK BEING DONE
VALUE (Including labor and all materials including light fixtures) $ '(~0 0 p
[] For applicable projects, an Electric Installation VeriEcation roma, sigmed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Pemfit is required.
9/o2
89/02/200~ 21:53 9202317255 ~EEZ ELECTRIC PAGE 83
Electric Installation Verification
(I') 01/'c) Beez Electric. Inc.
521 W. 12th Oshkosh ~_ 54902
have been contra~ted '~o perform electric iasrallation work for Marx Mechanical,
al the following address: ,~ 080 I~ Westfield St, V~fllage ~216,
The nature of the work consists of: (Check One or Describe the Nature otWork)
Reeonnection or new circuit for replacement Heating Plan~ end/or A/C Condenser,
Reconne~tion or new circuit for replacement Electric Water Heater.
Reeonnection of~e Send0e Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures due to siding / soffit installation. Note: New Service Entrance Cables
will require a sel~erate permit.
Reeonnection or new circuit for ether permanently wired appliances / fixtures.
The value of this work is $150.0(~
I hereby verii~ this work will be performed by an employee of this company and further verify the
reeonnection I las~alla£ion will be done in compliance with ~a~urer md Electric code
requirements,
(Signature of Company Officer)
Gar~ Bj.esinger 09/03/03