HomeMy WebLinkAbout0098902-ElectricOSHKOSH
ON THE WATER
Job Address 2721 HAMILTON ST Owner
Contractor VAN ERT ELECTRIC Category
Service ~ New O Change (~ Temp I
Volts 120/240 Circuits
Amps 200 Switches
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
CREATIVE CUSTOM HOMES & DEVELOP
611 - Residential-New Single Family Wirin
Type (~ Overhead
20
25
No 98902
Create Date 12/04/2002
Plan
(~) Underground
Fixtures
Receptacles
65
Appliances ~ange, Dishwasher, Garbage Disposal, Dryer, Fan or Blower, Furnace, NC & Motors.
Use/Nature of NSFPJ Install electrical for new home. *Job #F1512-BA.
Work
Fees: Valuation $4,000.00 Plan Approval $0.00
Issued By:
Permit Fee Paid $90.00
Date 12/04/2002
[] 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 2000 PROGRESS WAY KAUKUANA WI 54130 - 0 Telephone Number
920-766-3888
~2/02/02
15:~2 FAX 920 766 08~3 VAN ERT ELECTRIC
!
Van Ezt
ELECTRIC COMPANY, INC.
:2000 Progress Way, Kaukauna, WI 54130
,,Tel: (920) 766-3888 Fax: (920) 766-0883
hffp://www.vanert.com
DATE:
COMPANY:
CONTACT NAME:
FAX NUMBER:
FAX COVER SHEET
~001
SENDER:
COMMENTS:
NUMBER OF PAGES INCLUD~IG.:COVEFI SHEET:
,~,2/02/02 15,:.~ FAX.___._9.20 766 0883 VA~ ERT ELECTRIC ~002
City of Oshkosh
Division of Inspection Serviccs
P.O- Box 1130
Oshkosh, WI $49034 130
Phone (920) 236-50~0
Fax (920) 236-~084
ELECTRICAL PERMIT APPLICATION
Ail infozmadon after bold categories must be pmvlded.
Incomplete applications will not be procesS,
· Application(s) and fcc(e) ~an be brought ~o City Hall, Room 205 or mailed to lmpection Services. PO Box 11Zg,
Oshkosh WI 54903-11281 Commencing work without permit(s) will re~ll in £ees being doubled or $100.00 plus'
non. hal permit tee, which ever is g~ater.
OR
If you are a contractor participating in the Permitr~ee Account System and ha~e adeq,uatg funds, check h.
ff -Vo,,,u want this t, ro C e.vsed :t, hrough vour account _tl~
CHECK [] ALL APPLICABLE
Sg CATEGORY
ingle Family Clbup~ex
13Multi-Family
' DChangc [~l~t Applicable
IrILL IN ~ APPROPRIATE BLANK WITH THE NU1M~ER
Phase
Amps ~ Switeh~ # 2~
I'lRental E]Commcrcial nInduatrial
TYPE ClOvcrhead KINot Applicable
Jnd~mund
Circuits #
Fixtures#
Cl~C~ I~ ALL APrUCA~, LE
?
OR Blower ~ ,u~ce
"DWater Heater
Sign
YAJ.,UE (l~l~ding labor an~l ~ll matlab in~ludlng I~Rht fizlur~) $
MASTER ELECTRICIAN ', I~/~_.
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