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HomeMy WebLinkAbout0098953-ElectricOSHKOSH ON THE WATER ,Job ,Address 2749 HAMILTON ST Contractor VAN ERT ELECTRIC Service ~) New 0 Change Volts 120/240 Amps 200 CITY OF OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD Owner CREATIVE CUSTOM HOMES & DEVELOP Category 611 - Residential-New Single Family Wirin O Temp I Type (~ Overhead Circuits 20 Switches 25 No 98953 Create Date 12/05/2002 Plan (~ Underground Fixtures Receptacles 17 65 Appliances ~ange, Dishwasher, Garbage Disposal, Dryer, Fan or Blower, Furnace, NC & Motors. Use/Nature of NSFPJ Install electrical for new home. *Job #F1512-BD. Work Fees: Valuation $4,000.00 Plan Approval $0.00 Issued By: Permit Fee Paid $90.00 Date 12/05/2002 [] Permit Voided J 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 RECEIVED Division of Inspection Services P.O. Box 1130 Oshkosh, WI 54903-1130 DEC 0 4 2002 Phone (920) 236-5050 Fax (920)236-5084 DEPARTMENT OFO/HKO/H COMMUNITY DEVELOPMENT o,,, ELECTRICAL PERMIT APPLICATION All information after bold categories must be provided. Incomplete applications will not be processed. · Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus normal permit fee, which ever is greater. ' OR If you are a contractor participating in the Per~t ff4e Account System and have adequate funds, check h ~f ¥ou want this processed through your accountN~/ ~r~O~ ~ ~ ~0~{~ ~ DATE IZi~ ~)~'- V,m CHECK [] ALL APPLICABLE ~E CATEGORY ~3,Single Family FIDuplex F1Multi-Family SERVICE~Iew FITemporary ' ' FlChange FINot Applicable FILL IN THE APPROPRIATE BLANK WITH TI~ NUMBER Volts ' [~-) / ~ Receptacles # . Phase Amps ~/'~h Switches # DRental TYPE VICommercial [3Industrial EIOverhead FINot Applicable ~<~Underground Circuits Fixtures CHECK RI ALL APPLICABLE ge ~ishwasher ~l~bage Disposal ~anOR Blower ~urnace /~Mot°rs []Gas pumps [] Other _ ?;kc4 -r el ~er FlWater Heater EIElectric Sign VALUE (Including labor an~l all materials including light fixtures) $