HomeMy WebLinkAbout0102720 EOSHKOSH
ON THE WATER
Job Address
Contractor
Service
Volts
1684 OHIO ST
BQ ELECTRIC SERVICES LLC
[~ New (~ Change (~ Temp
Amps 0
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner MR/MRS VIC C SAMARITONI
Category 612 - Residential-Single Family Addition/Ret
Type I~ Overhead
Circuits 0
Switches 0
No 102720
Create Date 06/02/2003
Plan
~ Underground
Fixtures
Receptacles
Appliances
Use/Nature of SFR/ Wiring for new 12'x15' three-seasons room off the rear of the house.
Work
Fees: Valuation
Issued By:
$400.00 Plan Approval $0.00 Permit Fee Paid
$20.00
Date 07/09/2003
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 2930 CONGER CT, PO BOX 346 OSHKOSH WI 54903 - 346 Telephone Number
(920) 233-9005
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
JUL O t ~oo~ O/HKO/H
ELECTRICAL P E R M !t, A~T~, ~/~!~F
Incornp]cte applications w~]l ~ot be pmcesse&
· Application(s) and fee(s) can be brought to Cit~ Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Comm4ncing work without permit(s) will resul~ in fees being doubled or $1.00.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
(f you want this processed through your account []
~ATE 'q --q - 03
,o. ADD ss Oh;O
OWNER U lc. ~qa. ma;'~ qvM
CONT~'CTOR ~0 ~I~'C ~'; c S~u;c%l CC.
CHECK [] ALL APPLICABLE
g~ CATEGORY
ngle Family [2Duplex ElMulti-Family
SERVICE FtNew ElTemporary
F1Change I"lNot Applicable
[2Rental r-lCommercial [2Lndustrial
TYPE F1Overhead ElNot Applicable
E1Underground
FILL IN THE APPROPRIATE BLANK WITH THE NUMBER
Volts / Receptacles #
Phase
Amps Switches #
Circuits #
Fixtures #
CHECK [] ALL APPLICABLE
F1Range [3Dishwasher E1Garbage Disposal F1Dryer FlWater Heater
E]Fan OR Blower [3Furnace EIA/C . IZ]Electric Sign
mMotors mGasPumps ~Oth¢~ LA)loC .~-.~oq
¥
DESCRIPTIONOFALLWORKBEINGDONE [A) t O ~. l'q, ~) lx) ~ 6c ~q
VALUE (Including labor and all m3teJ/i.a-j?s including light~tures) $ k,.4_C)~,/.DO
3/02