HomeMy WebLinkAbout0098992-HVAC (furnace & separate duct work)City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
Oshkosh Wl 54903-1130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Verification
(Electrical Contractor Name)
(City) (State)
(Address) (Zip Code)
have been contracted to perform electric installation work for A'~b/VgJt £ J--/C-T/~.7-2/ld G,
(Name of party contracted to)
at the following address: [~0 (o (.,,4,/~ &o0
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: .New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of A/C to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ ~D'6. o ~
I hereby verify this work will be performed by an employee of this company and further verify
the recormection / installation will be done in compliance with manufacturer and Electric code
requirements.
(Si gnatur&-o f-Company Officer)
(Print Name of Officer)
(Date)
5/02