HomeMy WebLinkAbout0103863-ElectricOSHKOSH
ON THE WATER
.lob Address 3209 BELLFIELD DR
Contractor VAN ERT ELECTRIC
Service [~ New (~ Change
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner CREATIVE CUSTOM HOMES & DEVELOP I
Category 611 - Residential-New Single Family Wiring
Amps 200
~ Temp
Type I~ Overhead
Circuits 20
Switches 30
No 103863
Create Date 07/23/2003
Plan
~ Underground
Fixtures
Receptacles
17
40
Appliances Range, Fan or Blower, Dishwasher, Furnace, A/C, Garbage Disposal, Dryer & Water Heater.
Use/Nature of NSFR/ Wire new house. *Job #F1562Y
Work
Fees: Valuation
Issued By:
$4,200.00 Plan Approval $0.00 Permit Fee Paid $105.00
Date 09/02/2003
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 2000 PROGRESS WAY KAUKUANA WI 54130 - 0 Telephone Number
920-766-3888
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.
08/27/02 12:29 FAX 920 768 0883 VAN ERT ELECTRIC ~003
City of osh~sh
Division of l~p~--c6on Services
P.O. Box I 1 }0
Oshkosh, WI $4903-1130
Phouc (920) 236-50.50
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
All ilfformation afar bold ca[cgorics must bc provided.
Incomplete applications will not bc processed.
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Insp~tion Services, PO Box 1128,
Oshkosh WI 54903-I 128. Commencing work without permit(s) will result in fees being doubled or $100.00
normal permit fee, whichever is great,r,
OR
If you are a contractor varticioatln~ in the_Perml-t F~e dccount System and have adeauate f~unds, checl
ifygu~vantthispr°cessedthr°ughy°uracc°unt~- DATE * t~,/05
CI~CK [~ ALL APPLICABLE
1~ CATEGORY
nglo Family VIDuplex VIMulti-Family
SERVICE ~:~a~ IqTemp°rary
ge ElNot Applicable
~Commercial CIInd~trial
TYPE ~[~Overhead FlNot Applicable
/~].Underground
FILL IN Tl~ APPROPRIATE BLANK WITH TH~ NUMBER
Volts ' 12~) I Z~4;~ Receptacles# . ~'~
Phase
Amps
Circuits
Fixtures ~ I "~
ElOabage Disposal
nA/C
DOther
ElDryer rlWater Heater
[3Electric Sign
CI~CK [~' ALL APPLICABLE
[3Range ClDishwasher
ClFan OR Blower ElFurnace
r-IMotors []Gas Pumps
VALIt.rE (Including labor and all materials including IigM fixtures) $ ; _
MASTER ELECTRICIAN