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CITY OF OSHKOSH
106922
No
OSHKOSHELECTRIC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job AddressOwnerCreate Date12/26/2003
1243 W 9TH AVEHABITAT FOR HUMANITY OF OSHKOSH INC
ContractorVAN ERT ELECTRICCategory611 - Residential-New Single Family WiringPlan
ServiceTypeOverheadUnderground
NewChangeTemp
Volts120/240Circuits17Fixtures17
Amps200Switches20Receptacles34
Range, Dryer, Furnace
Appliances
Use/Nature of NSF/ Wire new house.
Work
Plan Approval$0.00
Fees: Valuation$3,400.00Permit Fee Paid$98.00
Issued By:Date03/17/2004
Permit Voided
Parcel Id #1307690000
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.
SignatureDate
Agent/Owner
HABITAT FOR HUMANITY OF OSHKOSH INCOSHKOSHWI549010
Address-Telephone Number
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.
OSHKOSH
ON THE WATER
.lob Address 1243 W 9TH AVE
Contractor VAN ERT ELECTRIC
Service [~ New (~) Change
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner HABITAT FOR HUMANITY OF OSHKOSH I1~
Category 611 - Residential-New Single Family Wiring
Amps 200
~ Temp
Type I~ Overhead
Circuits 17
Switches 20
No 106922
Create Date 12/26/2003
Plan
~ Underground
Fixtures
Receptacles
17
34
Appliances
Use/Nature of NSF
Work
Fees: Valuation
Issued By:
$3,400.00 Plan Approval $0.00
Permit Fee Paid $98.00
Date 03/17/2004
Permit Voided
Parcel Id # 1307690000
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 HABITAT FOR HUMANITY OF OSHKOSI- OSHKOSH WI 54901 - 0 Telephone Number
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.