HomeMy WebLinkAbout0099711-ElectricOSHKOSH
ON THE WATER
.lob Address 3222 BELLFIELD DR
Contractor VAN ERT ELECTRIC
Service [~ New (~ Change
Volts 120/240
CITY OF OSHKOSH
ELECTRIC PERMIT - APPLICATION AND RECORD
Owner CREATIVE CUSTOM HOMES & DEVELOP I
Category 611 - Residential-New Single Family Wiring
Amps 200
~ Temp
Type I~ Overhead
Circuits 18
Switches 30
No 99711
Create Date 02/03/2003
Plan
~ Underground
Fixtures
Receptacles
17
60
Appliances Range, Dishwasher, Garbage Disposal, Dryer, Fan or Blower & Furnace.
Use/Nature of NSFR/ Wire new home. *Job #F1512-CQ.
Work
Fees: Valuation
Issued By:
$4,500.00 Plan Approval $0.00 Permit Fee Paid
$105.00
Date 02/06/2003
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
02/06/02 09:52 FAX 920 766 0883 VAN ERT ELECTRIC ~006/009
City o f Oshkosh
' 15ivision o f Inspection Services
P.O. Box 1130
Oshkosh, W154903-1130
Phone (920) 236-5050
Fax (920) 236-5084
ELECTRICAL PERMIT APPLICATION
Ali information after bold categories mu~t be provided.
Incomplete applications will not be processed.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or ma/led to Inspection Services, PO Box 1128.
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plu
normal permit fee, which ever is greater.
OR
If you are a.contractor p~rticipatin~ in (he Pern~ ~ee dccou.nt System and have .adequate funds, check
if ~,ou want this processed through your accoun~t ~
CHECK [] ALL APPLICABLE
CATEGORY
~!l~ngle Family
SERVICE~ew
nChange
F'lDuptex CIMulti~Family
12]Temporary
F1Not Applicable
[3Rental [3Commercial [3Industrial
TYPE I"lOverhead DNot Applicable
nderground
FILL IN TI~ APPROPRIATE BLANK WITH THE N-UMBER
yom 1'20~2 '
: . . ~ Receptacles #
Phase ~)~,Z '
Amps ~90-'~ Switches #
Circuits// [6
Fixtures # _t "'[
CHECK [] ALL APPLICABLE
~Range '~l~)ishwasher
..A~Fan OR Blower /,~umace
I"iMotors l"lGas Pumps
DESCRIPTION OF ALL WORK BEING DONE
..~l~arbage Disposal
f"IAJC I-IElectfic Sign
[3Other
l-IWater Heater
VALUE (Including l.abor an~ all materials including light fixtures) $ ~4~,
MASTER ELECTRICIAN
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