HomeMy WebLinkAbout0103176-ElectricOSHKOSH
ON THE WATER
Job Address 3237 BELLFIELD DR
Contractor VAN ERT ELECTRIC
Service ~ New O Change
Volts 120/240
Amps 200
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
No 103176
(~Temp
Owner CREATIVE CUSTOM HOMES & DEVELOP Create Date 04/28/2003
Category 611 - Residential-New Single Family Wirin Plan
j Type O Overhead O Underground
Circuits 20 Fixtures
Switches 30 Receptacles
13
60
Appliances ~ange, Dishwasher. Garbage Disposal, Dryer, Furnace & NC.
Use/Nature of 4SFPJ Wire new home. *Job #F1562M
Work
Fees: Valuation $4,200.00 Plan Approval $0.00 Permit Fee Paid $105.00
Issued By:
Date 07/29/2003
[] Permit Voided J
In the performance of this work I agree to perform all work pumuant to rules governing the described construction.
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 236.5'128 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.
~ · ~7/28/02 09:45 FAX 920 766 0883__ VAN ERT ELECTRIC ~003
City of Oshkosh
Division of Inspection Services
P.O. Box I 130
Oshkosh, Wl 54903-1130
Phone (920) 236-5050
Fax (920) 2365084
ELECTRICAL PERMIT APPLICATION
Ail information after bold categories mast bc provided.
Incomplete applicatioox will not be processed.
Of HKO,/H
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commonoing work without permit(s) will result in fees being doubled or $100.00 plus
normal permit fee, which ever is greater.
OR
[f you are a contractor nartici~atinff in the Permit ~.ee Account System and have adeauate £u~d$, check f
if you want tt~i~ ~rocessed through your account ~ ~]. _. l~)/~
DATE__
CHECK RI ALL APPLICABLE
~[~sE CATEGORY
ingle Family U1Duplex E]Multi-Famity
SERVICE ~¢w r'lTemporary
12Change I~Not Applicable
ElRental mCommcrc[al ElIndustrial
TYPE ElOverbead ONot Applicable
F'lUndcrground
ci,-e,.,its # 0__,
CHECK [] ALL APPLICABLE
VIFan OR Blower
VIMotors
VIGas Pumps
Disposal
~El~t~ic Sign VJWater Heater
DESCRIPTIONOFAIJ, WORKBEINGDONE (-A-~{'J~ ~ a~x~/~~
VALUE (Including labor and all materials including Hght fixtures)
MASTER ELECTRICIAN