HomeMy WebLinkAbout0098954-ElectricOSHKOSH.
ON THE WATER
Job Address 2769 HAMILTON ST Owner
Contractor VAN ERT ELECTRIC Category
Service ~ New (~) Change (~ Temp t
Volts 120/240 Circuits
Amps 200 Switches
CITY OF OSHKOSH
ELECTRIC PERMIT -APPLICATION AND RECORD
CREATIVE CUSTOM HOMES & DEVELOP
611 - Residential-New Single Family Widn
Type ~) Overhead
20
25
No 98954
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 NSFR/Install electrical for new home. *Job #F1512-BF.
Work
Fees: Valuation $4,000.00 Plan Approval $0.00
Issued By:
Permit Fee Paid $90.00
Date 12/05/2002
[] Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
AgentJOwner
Address 2000 PROGRESS WAY KAUKUANA WI 54130 - 0 . Telephone Number
920-766-3888
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236°5050
Fax (920) 236-5084
RECEIVED
DEC 0 4 2002
E L E CT RI C Al~j~T~/lr~[l~O N
All information aftei §bTdZ~t~driL~rfl6~-b~d light,lSd.
Incomplete applications will not be processed.
O/HKO/H
ON THE WATER
· 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 Pernlit Feg Account System and have adequate funds, check
if you want this processed through your accoun'X~f~
CHECK [] ALL APPLICABLE
ln CATEGORY
gle Family
SERVICE~i[~ew
-I-IChange
FIDuplex UlMulti-Family
F1Temporary
FINot Applicable
FIRental F'lCommercial Fllndustrial
TYPE UIO_verhead F1Not Applicable
nderground
FILL IN ~ APPROPRIATE BLANK WITH THE NUMBER
Volts · { ?0. / ~ Receptacles
AmpsPhase ~//~) Switches #
Circuits
Fixtures#
CI4ECK [] ALL APPLICABLE
Range __~ ishwasher
an OR Blower ' J~ umace
otors 'VIGas Pumps
~~o}arbage DisPosal
~er
E~er
lectric Sign
DESCRIPTION OF ALL WORK BEING DONE
FlWater Heater
VALUE (Including labor and all materials including light fixtures) $
MASTER ELECTRICIAN