HomeMy WebLinkAbout0098904-Electric CITY OF OSHKOSH
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2739 HAMILTON ST Owner CREATIVE CUSTOM HOMES & DEVELOP
Contractor VAN ERT ELECTRIC Category 611 - Residential-New Single Family Wirin
Service ~ New (~) Change (~) Temp I Type (~ Overhead
Volts 120/240 Circuits 20
Amps 200 Switches 25
No 98904
Create Date 12/04/2002
Plan
(~ Underground
Fixtures
Receptacles
65
Appliances Range, Dishwasher, Garbage Disposal, Dryer, Fan or Blower, Fumace, A/C & Motors.
Use/Nature of NSFPJ Install electrical for new home. *Job #F1512-BC.
Work
Fees: Valuation $4,000.00 Plan Approval $0.00 Permit Fee Paid $90.00
Issued By:
[] Permit Voided
Date 12/04/2002
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
~2/92/02 15:12 FAX 920 766 05~3 VAN ERT ELECTRIC ~004
City of Oshkosl~
D/vision of Inspection Services
P.O. Box 1 ! 30
O~bko~h. WI $4903-1130
Phone (920) 236-5050
Fax
(920) 236-5084
ELECTRICAL PERMIT APPLICATION
AH information after bold categories nmst be p~ovided.
Incomplete applications will not bc processed.
· Application(s) and fee(s) !can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-I 12q. Commencing work wi~out permit(s) will xesult in fees being doubled or $100.00 plus'
normal permit fee, which~ever is greater.
OR
If you are a ¢ontra.cto. r t~a~tisf~atin~t_fn the Permit ~e.e~4~count System and bare adeauate funds, check__~.
ff you want tAis proces'sed!tAro, u~_A Your acC°un~~
CH~CK I/] ALL A.PPLICA~LE
.mglCATEGORY '
c Family l'-IDul~lex ~Multi-Family
SERF[ ~Tcmporary
~e I~.ot Applicable
FTI,1, IN ~ APPROPRL~TE BLANK WITH ~ NUMBF. R
Phase ~
Amps ~./_gD Switches #
[:]Rcntal EICommcrcial IZlIndustrial
TYPE IZiOverhead IZINo! Applicable
~nderground
Circuits
Fixtures
C~.CK [] .,aT,]. ,~PPLICM~LE
~_ _~gc ~hwnsher
OR Blow~
. u oto s Klci
DESCRIYI'ION OF ALL WORK BEING DONE
yc6arbage Disposal
[-lOther
C]Elcctric Sign
YALUE (Including labor and~all matexJnls including ilib~ fixtures)
MASTER ELECTRICIAN.
/3Water Heate~
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